System and method to enable remote adjustment of a device during a telemedicine session

ABSTRACT

A computer-implemented system comprising a treatment device, a patient interface, and a processing device is disclosed. The treatment device is configured to be manipulated by a user while the user performs a treatment plan. The patient interface comprises an output device configured to present telemedicine information associated with a telemedicine session. The processing device is configured to receive a treatment plan for a patient; during the telemedicine session, use the treatment plan to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the device.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.17/147,514, filed Jan. 13, 2021, titled “System and Method to EnableRemote Adjustment of a Device During a Telemedicine Session,” which is acontinuation-in-part of U.S. patent application Ser. No. 17/021,895,filed Sep. 15, 2020, titled “Telemedicine for Orthopedic Treatment,”which claims priority to and the benefit of U.S. Provisional PatentApplication Ser. No. 62/910,232, filed Oct. 3, 2019, titled“Telemedicine for Orthopedic Treatment,” the entire disclosures of whichare hereby incorporated by reference for all purposes. U.S. patentapplication Ser. No. 17/147,514 also claims priority to and the benefitof U.S. Provisional Patent Application Ser. No. 63/029,896, filed May26, 2020, titled “System and Method to Enable Remote Adjustment of aDevice During a Telemedicine Session,” the entire disclosures of whichare hereby incorporated by reference for all purposes.

TECHNICAL FIELD

This disclosure relates generally to a system and a method for enablinga remote adjustment of a device during a telemedicine session.

BACKGROUND

Remote medical assistance, also referred to, inter alia, as remotemedicine, telemedicine, telemed, telmed, tel-med, or telehealth, is anat least two-way communication between a healthcare provider orproviders, such as a physician or a physical therapist, and a patientusing audio and/or audiovisual and/or other sensorial or perceptive(e.g., tactile, gustatory, haptic, pressure-sensing-based orelectromagnetic (e.g., neurostimulation) communications (e.g., via acomputer, a smartphone, or a tablet). Telemedicine may aid a patient inperforming various aspects of a rehabilitation regimen for a body part.The patient may use a patient interface in communication with anassistant interface for receiving the remote medical assistance viaaudio, visual, audiovisual, or other communications described elsewhereherein. Any reference herein to any particular sensorial modality shallbe understood to include and to disclose by implication a different oneor more sensory modalities.

Telemedicine is an option for healthcare providers to communicate withpatients and provide patient care when the patients do not want to orcannot easily go to the healthcare providers' offices. Telemedicine,however, has substantive limitations as the healthcare providers cannotconduct physical examinations of the patients. Rather, the healthcareproviders must rely on verbal communication and/or limited remoteobservation of the patients.

SUMMARY

In general, the present disclosure provides a system and method forremote examination of patients through augmentation.

An aspect of the disclosed embodiments includes a computer-implementedsystem comprising a treatment device, a patient interface, and aprocessing device. The treatment device is configured to be manipulatedby a user while the user performs a treatment plan. The patientinterface comprises an output device configured to present telemedicineinformation associated with a telemedicine session. The processingdevice is configured to receive a treatment plan for a patient; duringthe telemedicine session, use the treatment plan to generate at leastone parameter; and responsive to at least one trigger conditionoccurring, control at least one operation of the device.

Another aspect of the disclosed embodiments includes a system forenabling a remote adjustment of a device. The system comprises a controlsystem comprising one or more processing devices operatively coupled tothe device. The one or more processing devices are configured to receivea treatment plan for a patient; use the treatment plan to generate atleast one parameter; and responsive to at least one trigger conditionoccurring, control at least one operation of the device.

Another aspect of the disclosed embodiments includes a system thatincludes a processing device and a memory communicatively coupled to theprocessing device and capable of storing instructions. The processingdevice executes the instructions to perform any of the methods,operations, or steps described herein.

Another aspect of the disclosed embodiments includes a tangible,non-transitory computer-readable medium storing instructions that, whenexecuted, cause a processing device to perform any of the methods,operations, or steps described herein.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of this disclosure and its advantages,reference is now made to the following description, taken in conjunctionwith the accompanying drawings. It is emphasized that, according tocommon practice, the various features of the drawings are not to-scale.On the contrary, the dimensions of the various features are arbitrarilyexpanded or reduced for clarity.

FIG. 1 generally illustrates a high-level component diagram of anillustrative system according to certain aspects of this disclosure.

FIGS. 2A-D generally illustrate example treatment devices according tocertain aspects of this disclosure.

FIG. 3 generally illustrates an example master device according tocertain aspects of this disclosure.

FIGS. 4A-D generally illustrate example augmented images according tocertain aspects of this disclosure.

FIG. 5 generally illustrates an example method of operating a remoteexamination system according to certain aspects of this disclosure.

FIG. 6 generally illustrates an example method of operating a remoteexamination system according to certain aspects of this disclosure.

FIG. 7 generally illustrates a high-level component diagram of anillustrative system for a remote adjustment of a device according tocertain aspects of this disclosure.

FIG. 8 generally illustrates a perspective view of an example of thedevice according to certain aspects of this disclosure.

FIG. 9 generally illustrates an example method of enabling a remoteadjustment of a device according to certain aspects of this disclosure.

FIG. 10 generally illustrates an example computer system according tocertain to certain aspects of this disclosure.

FIG. 11 generally illustrates a perspective view of an embodiment of thedevice, such as a treatment device according to certain aspects of thisdisclosure.

FIG. 12 generally illustrates a perspective view of a pedal of thetreatment device of FIG. 11 according to certain aspects of thisdisclosure.

FIG. 13 generally illustrates a perspective view of a person using thetreatment device of FIG. 11 according to certain aspects of thisdisclosure.

NOTATION AND NOMENCLATURE

Various terms are used to refer to particular system components.Different companies may refer to a component by different names—thisdocument does not intend to distinguish between components that differin name but not function. In the following discussion and in the claims,the terms “including” and “comprising” are used in an open-endedfashion, and thus should be interpreted to mean “including, but notlimited to . . . .” Also, the term “couple” or “couples” is intended tomean either an indirect or direct connection. Thus, if a first devicecouples to a second device, that connection may be through a directconnection or through an indirect connection via other devices andconnections.

The terminology used herein is for the purpose of describing particularexample embodiments only, and is not intended to be limiting. As usedherein, the singular forms “a,” “an,” and “the” may be intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. The method steps, processes, and operations described hereinare not to be construed as necessarily requiring their performance inthe particular order discussed or illustrated, unless specificallyidentified as an order of performance. It is also to be understood thatadditional or alternative steps may be employed.

The terms first, second, third, etc. may be used herein to describevarious elements, components, regions, layers and/or sections; however,these elements, components, regions, layers and/or sections should notbe limited by these terms. These terms may be only used to distinguishone element, component, region, layer, or section from another region,layer, or section. Terms such as “first,” “second,” and other numericalterms, when used herein, do not imply a sequence or order unless clearlyindicated by the context. Thus, a first element, component, region,layer, or section discussed below could be termed a second element,component, region, layer, or section without departing from theteachings of the example embodiments. The phrase “at least one of,” whenused with a list of items, means that different combinations of one ormore of the listed items may be used, and only one item in the list maybe needed. For example, “at least one of: A, B, and C” includes any ofthe following combinations: A, B, C, A and B, A and C, B and C, and Aand B and C. In another example, the phrase “one or more” when used witha list of items means there may be one item or any suitable number ofitems exceeding one.

Spatially relative terms, such as “inner,” “outer,” “beneath,” “below,”“lower,” “above,” “upper,” “top,” “bottom,” “inside,” “outside,”“contained within,” “superimposing upon,” and the like, may be usedherein. These spatially relative terms can be used for ease ofdescription to describe one element's or feature's relationship toanother element(s) or feature(s) as illustrated in the figures. Thespatially relative terms may also be intended to encompass differentorientations of the device in use, or operation, in addition to theorientation depicted in the figures. For example, if the device in thefigures is turned over, elements described as “below” or “beneath” otherelements or features would then be oriented “above” the other elementsor features. Thus, the example term “below” can encompass both anorientation of above and below. The device may be otherwise oriented(rotated 90 degrees or at other orientations) and the spatially relativedescriptions used herein interpreted accordingly.

A “treatment plan” may include one or more treatment protocols, and eachtreatment protocol includes one or more treatment sessions. Eachtreatment session comprises several session periods, with each sessionperiod including a particular exercise for treating the body part of thepatient. For example, a treatment plan for post-operative rehabilitationafter a knee surgery may include an initial treatment protocol withtwice daily stretching sessions for the first 3 days after surgery and amore intensive treatment protocol with active exercise sessionsperformed 4 times per day starting 4 days after surgery. A treatmentplan may also include information pertaining to a medical procedure toperform on the patient, a treatment protocol for the patient using atreatment device, a diet regimen for the patient, a medication regimenfor the patient, a sleep regimen for the patient, additional regimens,or some combination thereof.

The terms telemedicine, telehealth, telemed, teletherapeutic,telemedicine, remote medicine, etc. may be used interchangeably herein.

The term “optimal treatment plan” may refer to optimizing a treatmentplan based on a certain parameter or factors or combinations of morethan one parameter or factor, such as, but not limited to, a measure ofbenefit which one or more exercise regimens provide to users, one ormore probabilities of users complying with one or more exerciseregimens, an amount, quality or other measure of sleep associated withthe user, information pertaining to a diet of the user, informationpertaining to an eating schedule of the user, information pertaining toan age of the user, information pertaining to a sex of the user,information pertaining to a gender of the user, an indication of amental state of the user, information pertaining to a genetic conditionof the user, information pertaining to a disease state of the user, anindication of an energy level of the user, information pertaining to amicrobiome from one or more locations on or in the user (e.g., skin,scalp, digestive tract, vascular system, etc.), or some combinationthereof.

As used herein, the term healthcare provider may include a medicalprofessional (e.g., such as a doctor, a nurse, a therapist, and thelike), an exercise professional (e.g., such as a coach, a trainer, anutritionist, and the like), or another professional sharing at leastone of medical and exercise attributes (e.g., such as an exercisephysiologist, a physical therapist, an occupational therapist, and thelike). As used herein, and without limiting the foregoing, a “healthcareprovider” may be a human being, a robot, a virtual assistant, a virtualassistant in virtual and/or augmented reality, or an artificiallyintelligent entity, such entity including a software program, integratedsoftware and hardware, or hardware alone.

DETAILED DESCRIPTION

The following discussion is directed to various embodiments of thepresent disclosure. Although one or more of these embodiments may bepreferred, the embodiments disclosed should not be interpreted, orotherwise used, as limiting the scope of the disclosure, including theclaims. In addition, one skilled in the art will understand that thefollowing description has broad application, and the discussion of anyembodiment is meant only to be exemplary of that embodiment, and notintended to intimate that the scope of the disclosure, including theclaims, is limited to that embodiment.

Determining optimal remote examination procedures to create an optimaltreatment plan for a patient having certain characteristics (e.g.,vital-sign or other measurements; performance; demographic; geographic;psychographic; diagnostic; measurement- or test-based; medicallyhistoric; behavioral historic; cognitive; etiologic; cohort-associative;differentially diagnostic; surgical, physically therapeutic,pharmacologic and other treatment(s) recommended; etc.) may be atechnically challenging problem. For example, a multitude of informationmay be considered when determining a treatment plan, which may result ininefficiencies and inaccuracies in the treatment plan selection process.In a rehabilitative setting, some of the multitude of informationconsidered may include characteristics of the patient such as personalinformation, performance information, and measurement information. Thepersonal information may include, e.g., demographic, psychographic orother information, such as an age, a weight, a gender, a height, a bodymass index, a medical condition, a familial medication history, aninjury, a medical procedure, a medication prescribed, or somecombination thereof. The performance information may include, e.g., anelapsed time of using a treatment device, an amount of force exerted ona portion of the treatment device, a range of motion achieved on thetreatment device, a movement speed of a portion of the treatment device,a duration of use of the treatment device, an indication of a pluralityof pain levels using the treatment device, or some combination thereof.The measurement information may include, e.g., a vital sign, arespiration rate, a heartrate, a temperature, a blood pressure, aglucose level or other biomarker, or some combination thereof. It may bedesirable to process and analyze the characteristics of a multitude ofpatients, the treatment plans performed for those patients, and theresults of the treatment plans for those patients.

Further, another technical problem may involve distally treating, via acomputing device during a telemedicine session, a patient from alocation different than a location at which the patient is located. Anadditional technical problem is controlling or enabling, from thedifferent location, the control of a treatment apparatus used by thepatient at the patient's location. Oftentimes, when a patient undergoesrehabilitative surgery (e.g., knee surgery), a medical professional mayprescribe a treatment apparatus to the patient to use to perform atreatment protocol at their residence or at any mobile location ortemporary domicile. A medical professional may refer to a doctor,physician assistant, nurse, chiropractor, dentist, physical therapist,acupuncturist, physical trainer, or the like. A medical professional mayrefer to any person with a credential, license, degree, or the like inthe field of medicine, physical therapy, rehabilitation, or the like.

When the healthcare provider is located in a location different from thepatient and the treatment device, it may be technically challenging forthe healthcare provider to monitor the patient's actual progress (asopposed to relying on the patient's word about their progress) in usingthe treatment device, modify the treatment plan according to thepatient's progress, adapt the treatment device to the personalcharacteristics of the patient as the patient performs the treatmentplan, and the like. Further, in addition to the information describedabove, determining optimal examination procedures for a particularailment (e.g., injury, disease, any applicable medical condition, etc.)may include physically examining the injured body part of a patient. Thehealthcare provider, such as a physician or a physical therapist, mayvisually inspect the injured body part (e.g., a knee joint). Theinspection may include looking for signs of inflammation or injury(e.g., swelling, redness, and warmth), deformity (e.g., symmetricaljoints and abnormal contours and/or appearance), or any other suitableobservation. To determine limitations of the injured body part, thehealthcare provider may observe the injured body part as the patientattempts to perform normal activity (e.g., bending and extending theknee and gauging any limitations to the range of motion of the injuredknee). The healthcare provide may use one or more hands and/or fingersto touch the injured body part. By applying pressure to the injured bodypart, the healthcare provider can obtain information pertaining to theextent of the injury. For example, the healthcare provider's fingers maypalpate the injured body part to determine if there is point tenderness,warmth, weakness, strength, or to make any other suitable observation.

It may be desirable to compare characteristics of the injured body partwith characteristics of a corresponding non-injured body part todetermine what an optimal treatment plan for the patient may be suchthat the patient can obtain a desired result. Thus, the healthcareprovider may examine a corresponding non-injured body part of thepatient. For example, the healthcare provider's fingers may palpate anon-injured body part (e.g., a left knee) to determine a baseline of howthe patient's non-injured body part feels and functions. The healthcareprovider may use the results of the examination of the non-injured bodypart to determine the extent of the injury to the corresponding injuredbody part (e.g., a right knee). Additionally, injured body parts mayaffect other body parts (e.g., a knee injury may limit the use of theaffected leg, leading to atrophy of leg muscles). Thus, the healthcareprovider may also examine additional body parts of the patient forevidence of atrophy of or injury to surrounding ligaments, tendons,bones, and muscles, examples of muscles being such as quadriceps,hamstrings, or calf muscle groups of the leg with the knee injury. Thehealthcare provider may also obtain information as to a pain level thatthe patient reports or experiences before, during, and/or after theexamination.

The healthcare provider can use the information obtained from theexamination (e.g., the results of the examination) to determine a propertreatment plan for the patient. If the healthcare provider cannotconduct a physical examination of the one or more body parts of thepatient, the healthcare provider may not be able to fully assess thepatient's injury and the treatment plan may not be optimal. Accordingly,embodiments of the present disclosure pertain to systems and methods forconducting a remote examination of a patient. The remote examinationsystem provides the healthcare provider with the ability to conduct aremote examination of the patient, not only by communicating with thepatient, but by virtually observing and/or feeling the patient's one ormore body parts.

In some embodiments, the systems and methods described herein may beconfigured to use a treatment device configured to be manipulated by anindividual while the user performs a treatment plan. The individual mayinclude a user, patient, or other a person using the treatment device toperform various exercises for prehabilitation, rehabilitation, stretchtraining, and the like. The systems and methods described herein may beconfigured to use and/or provide a patient interface comprising anoutput device configured to present telemedicine information associatedwith a telemedicine session.

In some embodiments, the systems and methods described herein may beconfigured to receive a treatment plan for a patient; during thetelemedicine session, use the treatment plan to generate at least oneparameter; and responsive to at least one trigger condition occurring,control at least one operation of the device. Any or all of the methodsdescribed may be implemented during a telemedicine session or at anyother desired time.

In some embodiments, the treatment devices may be communicativelycoupled to a server. Characteristics of the patients, including thetreatment data, may be collected before, during, and/or after thepatients perform the treatment plans. For example, any or each of thepersonal information, the performance information, and the measurementinformation may be collected before, during, and/or after a patientperforms the treatment plans. The results (e.g., improved performance ordecreased performance) of performing each exercise may be collected fromthe treatment device throughout the treatment plan and after thetreatment plan is performed. The parameters, settings, configurations,etc. (e.g., position of pedal, amount of resistance, etc.) of thetreatment device may be collected before, during, and/or after thetreatment plan is performed.

Each characteristic of the patient, each result, and each parameter,setting, configuration, etc. may be timestamped and may be correlatedwith a particular step or set of steps in the treatment plan. Such atechnique may enable the determination of which steps in the treatmentplan lead to desired results (e.g., improved muscle strength, range ofmotion, etc.) and which steps lead to diminishing returns (e.g.,continuing to exercise after 3 minutes actually delays or harmsrecovery).

Data may be collected from the treatment devices and/or any suitablecomputing device (e.g., computing devices where personal information isentered, such as the interface of the computing device described herein,a clinician interface, patient interface, and the like) over time as thepatients use the treatment devices to perform the various treatmentplans. The data that may be collected may include the characteristics ofthe patients, the treatment plans performed by the patients, the resultsof the treatment plans, any of the data described herein, any othersuitable data, or a combination thereof.

In some embodiments, the data may be processed to group certain peopleinto cohorts. The people may be grouped by people having certain orselected similar characteristics, treatment plans, and results ofperforming the treatment plans. For example, athletic people having nomedical conditions who perform a treatment plan (e.g., use the treatmentdevice for 30 minutes a day 5 times a week for 3 weeks) and who fullyrecover may be grouped into a first cohort. Older people who areclassified obese and who perform a treatment plan (e.g., use thetreatment plan for 10 minutes a day 3 times a week for 4 weeks) and whoimprove their range of motion by 75 percent may be grouped into a secondcohort.

In some embodiments, an artificial intelligence engine may include oneor more machine learning models that are trained using the cohorts. Insome embodiments, the artificial intelligence engine may be used toidentify trends and/or patterns and to define new cohorts based onachieving desired results from the treatment plans and machine learningmodels associated therewith may be trained to identify such trendsand/or patterns and to recommend and rank the desirability of the newcohorts. For example, the one or more machine learning models may betrained to receive an input of characteristics of a new patient and tooutput a treatment plan for the patient that results in a desiredresult. The machine learning models may match a pattern between thecharacteristics of the new patient and at least one patient of thepatients included in a particular cohort. When a pattern is matched, themachine learning models may assign the new patient to the particularcohort and select the treatment plan associated with the at least onepatient. The artificial intelligence engine may be configured tocontrol, distally and based on the treatment plan, the treatment devicewhile the new patient uses the treatment device to perform the treatmentplan.

As may be appreciated, the characteristics of the new patient (e.g., anew user) may change as the new patient uses the treatment device toperform the treatment plan. For example, the performance of the patientmay improve quicker than expected for people in the cohort to which thenew patient is currently assigned. Accordingly, the machine learningmodels may be trained to dynamically reassign, based on the changedcharacteristics, the new patient to a different cohort that includespeople having characteristics similar to the now-changed characteristicsas the new patient. For example, a clinically obese patient may loseweight and no longer meet the weight criterion for the initial cohort,result in the patient's being reassigned to a different cohort with adifferent weight criterion.

A different treatment plan may be selected for the new patient, and thetreatment device may be controlled, distally (e.g., which may bereferred to as remotely) and based on the different treatment plan,while the new patient uses the treatment device to perform the treatmentplan. Such techniques may provide the technical solution of distallycontrolling a treatment device.

Further, the systems and methods described herein may lead to fasterrecovery times and/or better results for the patients because thetreatment plan that most accurately fits their characteristics isselected and implemented, in real-time, at any given moment. “Real-time”may also refer to near real-time, which may be less than 10 seconds orany reasonably proximate difference between two different times. Asdescribed herein, the term “results” may refer to medical results ormedical outcomes. Results and outcomes may refer to responses to medicalactions. The term “medical action(s)” may refer to any suitable actionperformed by the medical professional, and such action or actions mayinclude diagnoses, prescription of treatment plans, prescription oftreatment devices, and the making, composing and/or executing ofappointments, telemedicine sessions, prescription of medicines,telephone calls, emails, text messages, and the like.

Depending on what result is desired, the artificial intelligence enginemay be trained to output several treatment plans. For example, oneresult may include recovering to a threshold level (e.g., 75% range ofmotion) in a fastest amount of time, while another result may includefully recovering (e.g., 100% range of motion) regardless of the amountof time. The data obtained from the patients and sorted into cohorts mayindicate that a first treatment plan provides the first result forpeople with characteristics similar to the patient's, and that a secondtreatment plan provides the second result for people withcharacteristics similar to the patient.

Further, the artificial intelligence engine may be trained to outputtreatment plans that are not optimal i.e., sub-optimal, nonstandard, orotherwise excluded (all referred to, without limitation, as “excludedtreatment plans”) for the patient. For example, if a patient has highblood pressure, a particular exercise may not be approved or suitablefor the patient as it may put the patient at unnecessary risk or eveninduce a hypertensive crisis and, accordingly, that exercise may beflagged in the excluded treatment plan for the patient. In someembodiments, the artificial intelligence engine may monitor thetreatment data received while the patient (e.g., the user) with, forexample, high blood pressure, uses the treatment device to perform anappropriate treatment plan and may modify the appropriate treatment planto include features of an excluded treatment plan that may providebeneficial results for the patient if the treatment data indicates thepatient is handling the appropriate treatment plan without aggravating,for example, the high blood pressure condition of the patient. In someembodiments, the artificial intelligence engine may modify the treatmentplan if the monitored data shows the plan to be inappropriate orcounterproductive for the user.

In some embodiments, the treatment plans and/or excluded treatment plansmay be presented, during a telemedicine or telehealth session, to ahealthcare provider. The healthcare provider may select a particulartreatment plan for the patient to cause that treatment plan to betransmitted to the patient and/or to control, based on the treatmentplan, the treatment device. In some embodiments, to facilitatetelehealth or telemedicine applications, including remote diagnoses,determination of treatment plans and rehabilitative and/or pharmacologicprescriptions, the artificial intelligence engine may receive and/oroperate distally from the patient and the treatment device.

In such cases, the recommended treatment plans and/or excluded treatmentplans may be presented simultaneously with a video of the patient inreal-time or near real-time during a telemedicine or telehealth sessionon a user interface of a computing device of a medical professional. Thevideo may also be accompanied by audio, text and other multimediainformation and/or other sensorial or perceptive (e.g., tactile,gustatory, haptic, pressure-sensing-based or electromagnetic (e.g.,neurostimulation). Real-time may refer to less than or equal to 2seconds. Near real-time may refer to any interaction of a sufficientlyshort time to enable two individuals to engage in a dialogue via suchuser interface, and will generally be less than 10 seconds (or anysuitably proximate difference between two different times) but greaterthan 2 seconds.

Presenting the treatment plans generated by the artificial intelligenceengine concurrently with a presentation of the patient video may providean enhanced user interface because the healthcare provider may continueto visually and/or otherwise communicate with the patient while alsoreviewing the treatment plans on the same user interface. The enhanceduser interface may improve the healthcare provider's experience usingthe computing device and may encourage the healthcare provider to reusethe user interface. Such a technique may also reduce computing resources(e.g., processing, memory, network) because the healthcare provider doesnot have to switch to another user interface screen to enter a query fora treatment plan to recommend based on the characteristics of thepatient. The artificial intelligence engine may be configured toprovide, dynamically on the fly, the treatment plans and excludedtreatment plans.

In some embodiments, the treatment device may be adaptive and/orpersonalized because its properties, configurations, and positions maybe adapted to the needs of a particular patient. For example, the pedalsmay be dynamically adjusted on the fly (e.g., via a telemedicine sessionor based on programmed configurations in response to certainmeasurements being detected) to increase or decrease a range of motionto comply with a treatment plan designed for the user. In someembodiments, a healthcare provider may adapt, remotely during atelemedicine session, the treatment device to the needs of the patientby causing a control instruction to be transmitted from a server totreatment device. Such adaptive nature may improve the results ofrecovery for a patient, furthering the goals of personalized medicine,and enabling personalization of the treatment plan on a per-individualbasis.

FIGS. 1-13, discussed below, and the various embodiments used todescribe the principles of this disclosure are by way of illustrationonly and should not be construed in any way to limit the scope of thedisclosure.

FIG. 1 illustrates a high-level component diagram of an illustrativeremote examination system 100 according to certain embodiments of thisdisclosure. In some embodiments, the remote examination system 100 mayinclude a slave computing device 102 communicatively coupled to a slavedevice, such as a treatment device 106. The treatment device can includea slave sensor 108 and a slave pressure system 110. The slave pressuresystem can include a slave motor 112. The remote examination system mayalso be communicatively coupled to an imaging device 116. Each of theslave computing device 102, the treatment device 106, and the imagingdevice 116 may include one or more processing devices, memory devices,and network interface cards. The network interface cards may enablecommunication via a wireless protocol for transmitting data over shortdistances, such as Bluetooth, ZigBee, etc. In some embodiments, theslave computing device 102 is communicatively coupled to the treatmentdevice 106 and the imaging device 116 via Bluetooth.

Additionally, the network interface cards may enable communicating dataover long distances, and in one example, the slave computing device 102may communicate with a network 104. The network 104 may be a publicnetwork (e.g., connected to the Internet via wired (Ethernet) orwireless (WiFi)), a private network (e.g., a local area network (LAN) orwide area network (WAN)), or a combination thereof. The slave computingdevice 102 may be communicatively coupled with one or more mastercomputing devices 122 and a cloud-based computing system 142.

The slave computing device 102 may be any suitable computing device,such as a laptop, tablet, smartphone, or computer. The slave computingdevice 102 may include a display capable of presenting a user interface,such as a patient portal 114. The patient portal 114 may be implementedin computer instructions stored on the one or more memory devices of theslave computing device 102 and executable by the one or more processingdevices of the slave computing device 102. The patient portal 114 maypresent various screens to a patient that enable the patient to view hisor her medical records, a treatment plan, or progress during thetreatment plan; to initiate a remote examination session; to controlparameters of the treatment device 106; to view progress ofrehabilitation during the remote examination session; or combinationthereof. The slave computing device 102 may also include instructionsstored on the one or more memory devices that, when executed by the oneor more processing devices of the slave computing device 102, performoperations to control the treatment device 106.

The slave computing device 102 may execute the patient portal 114. Thepatient portal 114 may be implemented in computer instructions stored onthe one or more memory devices of the slave computing device 102 andexecutable by the one or more processing devices of the slave computingdevice 102. The patient portal 114 may present various screens to apatient which enable the patient to view a remote examination providedby a healthcare provider, such as a physician or a physical therapist.The patient portal 114 may also provide remote examination informationfor a patient to view. The examination information can include a summaryof the examination and/or results of the examination in real-time ornear real-time, such as measured properties (e.g., angles ofbend/extension, pressure exerted on the treatment device 106, images ofthe examined/treated body part, vital signs of the patient, such asheart rate, temperature, etc.) of the patient during the examination.The patient portal 114 may also provide the patient's healthinformation, such as a health history, a treatment plan, and a progressof the patient throughout the treatment plan. So the examination of thepatient may begin, the examination information specific to the patientmay be transmitted via the network 104 to the cloud-based computingsystem 142 for storage and/or to the slave computing device 102.

The treatment device 106 may be an examination device for a body part ofa patient. As illustrated in FIGS. 2A-D, the treatment device 106 can beconfigured in alternative arrangements and is not limited to the exampleembodiments described in this disclosure. Although not illustrated, thetreatment device 106 can include a slave motor 112 and a motorcontroller 118. The treatment device 106 can include a slave pressuresystem 110. The slave pressure system 110 is any suitable pressuresystem configured to increase and/or decrease the pressure in thetreatment device 106. For example, the slave pressure system 110 cancomprise the slave motor 112, the motor controller 118, and a pump. Themotor controller 118 can activate the slave motor 112 to cause a pump orany other suitable device to inflate or deflate one or more sections 210of the treatment device 106. The treatment device 106 can be operativelycoupled to one or more slave processing devices. The one or more slaveprocessing devices can be configured to execute instructions inaccordance with aspects of this disclosure.

As illustrated in FIG. 2A, the treatment device 106 may comprise a brace202 (e.g., a knee brace) configured to fit on the patient's body part,such as an arm, a wrist, a neck, a torso, a leg, a knee, an ankle, hips,or any other suitable body part. The brace 202 may include slave sensors108. The slave sensors 108 can be configured to detect informationassociated with the patient. For example, the slave sensors 108 candetect a measured level of force exerted from the patient to thetreatment device 106, a temperature of the one or more body parts incontact with the patient, a movement of the treatment device 106, anyother suitable information, or any combination thereof. The brace 202may include sections 210. The sections 210 can be formed as one or morechambers. The sections 210 may be configured to be filled with a liquid(e.g., a gel, air, water, etc.). The sections 210 may be configured inone or more shapes, such as, but not limited to rectangles, squares,diamonds circles, trapezoids, any other suitable shape, or combinationthereof. The sections 210 may be the same or different sizes. Thesections 210 may be positioned throughout the treatment device 106. Thesections 210 can be positioned on the brace 202 above a knee portion,below the knee portion, and along the sides of the knee portion. In someembodiments, the brace 202 may include sections 210 positioned adjacentto each other and positioned throughout the brace 202. The sections 210are not limited to the exemplary illustrations in FIG. 4. The brace 202may include the one or more materials for the brace 202 and, in someembodiments, straps coupled to the brace 202. The brace 202 be formedfrom metal, foam, plastic, elastic, or any suitable material orcombination of materials. The brace 202 may be formed in any suitableshape, size, or design.

As illustrated in FIG. 2B, the treatment device 106 may comprise a cap204 that can be configured to fit onto the patient's head. FIG. 2Billustrates exemplary layers of the treatment device 106. The treatmentdevice 106 may include a first layer 212 and a second layer 214. Thefirst layer may be an outer later and the second layer 214 may be aninner layer. The second layer 214 may include the sections 210 and oneor more sensors 108. In this example embodiment, the sections 210 arecoupled to and/or from portions of the second layer 214. The sections210 can be configured in a honeycomb pattern. The one or more sensors108 may be coupled to the first layer 212. The first layer 212 can becoupled to the second layer 214. The first layer 212 can be designed toprotect the sections 210 and the sensors 108. The cap 204 may include astrap. The cap 204 and/or the strap be formed from metal, foam, plastic,elastic, or any suitable material or combination of materials. The cap204 may be formed in any suitable shape, size, or design.

As illustrated in FIG. 2C, the slave may comprise a mat 206. The mat 206may be configured for a patient to lie or sit down, or to stand upon.The mat 206 may include one or more sensors 108. The mat 206 may includeone or more sections 210. The sections 210 in the treatment device 106can be configured in a square grid pattern. The one or more sensors 108may be coupled to and/or positioned within the one or more sections 210.The mat 206 can be rectangular, circular, square, or any other suitableconfiguration. The mat 206 be formed from metal, foam, plastic, elastic,or any suitable material or combination of materials. The mat 206 mayinclude one or more layers, such as a top layer.

As illustrated in FIG. 2D, the slave may comprise a wrap 208. The wrap208 may be configured to wrap the wrap 208 around one or more portionsand/or one or more body parts of the patient. For example, the wrap 208may be configured to wrap around a person's torso. The wrap 208 mayinclude one or more sensors 108. The wrap 208 may include one or moresections 210. The sections 210 in the treatment device 106 can beconfigured in a diamond grid pattern. The one or more sensors 108 may becoupled to and/or positioned within the one or more sections 210. Thewrap 208 can be rectangular, circular, square, or any other suitableconfiguration. The wrap 208 may include a strap. The wrap 208 and/or thestrap be formed from metal, foam, plastic, elastic, or any suitablematerial or combination of materials.

The treatment device 106 may include at least one or more motorcontrollers 118 and one or more motors 112, such as an electric motor. Apump, not illustrated, may be operatively coupled to the motor. The pumpmay be a hydraulic pump or any other suitable pump. The pump may beconfigured to increase or decrease pressure within the treatment device106. The size and speed of the pump may determine the flow rate (i.e.,the speed that the load moves) and the load at the slave motor 112 maydetermine the pressure in one or more sections 210 of the treatmentdevice 106. The pump can be activated to increase or decrease pressurein the one or more sections 210. One or more of the sections 210 mayinclude a sensor 108. The sensor 108 can be a sensor for detectingsignals, such as a measured level of force, a temperature, or any othersuitable signal. The motor controller 118 may be operatively coupled tothe motor 112 and configured to provide commands to the motor 112 tocontrol operation of the motor 112. The motor controller 118 may includeany suitable microcontroller including a circuit board having one ormore processing devices, one or more memory devices (e.g., read-onlymemory (ROM) and/or random access memory (RAM)), one or more networkinterface cards, and/or programmable input/output peripherals. The motorcontroller 118 may provide control signals or commands to drive themotor 112. The motor 112 may be powered to drive the pump of thetreatment device 106. The motor 112 may provide the driving force to thepump to increase or decrease pressure at configurable speeds. Further,the treatment device 106 may include a current shunt to provideresistance to dissipate energy from the motor 112. In some embodiments,the treatment device 106 may comprise a haptic system, a pneumaticsystem, any other suitable system, or combination thereof. For example,the haptic system can include a virtual touch by applying forces,vibrations, or motions to the patient through the treatment device 106.

The slave computing device 102 may be communicatively connected to thetreatment device 106 via a network interface card on the motorcontroller 118. The slave computing device 102 may transmit commands tothe motor controller 118 to control the motor 112. The network interfacecard of the motor controller 118 may receive the commands and transmitthe commands to the motor 112 to drive the motor 112. In this way, theslave computing device 102 is operatively coupled to the motor 112.

The slave computing device 102 and/or the motor controller 118 may bereferred to as a control system (e.g., a slave control system) herein.The patient portal 114 may be referred to as a patient user interface ofthe control system. The control system may control the motor 112 tooperate in a number of modes: standby, inflate, and deflate. The standbymode may refer to the motor 112 powering off so it does not provide adriving force to the one or more pumps. For example, if the pump doesnot receive instructions to inflate or deflate the treatment device 106,the motor 112 may remain turned off. In this mode, the treatment device106 may not provide additional pressure to the patient's body part(s).

The inflate mode may refer to the motor 112 receiving manipulationinstructions comprising measurements of pressure, causing the motor 112to drive the one or more pumps coupled to the one or more sections ofthe treatment device 106 to inflate the one or more sections. Themanipulation instruction may be configurable by the healthcare provider.For example, as the healthcare provider moves a master device 126, themovement is provided in a manipulation instruction for the motor 112 todrive the pump to inflate one or more sections of the treatment device106. The manipulation instruction may include a pressure gradient toinflate first and second sections in a right side of a knee brace tofirst and second measured levels of force and inflate a third section ina left side of the knee brace to a third measured level of force. Thefirst measured level of force correlates with the amount of pressureapplied to the master device 126 by the healthcare provider's firstfinger. The second measured level of force correlates with the amount ofpressure applied to the master device 126 by the healthcare provider'ssecond finger. The third measured level of force correlates with theamount of pressure applied to the master device 126 by the healthcareprovider's third finger.

The deflation mode may refer to the motor 112 receiving manipulationinstructions comprising measurements of pressure, causing the motor 112to drive the one or more pumps coupled to the one or more sections ofthe treatment device 106 to deflate the one or more sections. Themanipulation instruction may be configurable by the healthcare provider.For example, as the healthcare provider moves the master device 126, themovement is provided in a manipulation instruction for the motor 112 todrive the pump to deflate one or more sections of the treatment device106. The manipulation instruction may include a pressure gradient todeflate the first and second sections in the right side of the kneebrace to fourth and fifth measured levels of force and deflate the thirdsection in the left side of the knee brace to the third measured levelof force. The fourth measured level of force correlates with the amountof pressure applied to the master device 126 by the healthcareprovider's first finger. The fifth measured level of force correlateswith the amount of pressure applied to the master device 126 by thehealthcare provider's second finger. The sixth measured level of forcecorrelates with the amount of pressure applied to the master device 126by the healthcare provider's third finger. In this example, thehealthcare provider loosened a grip (e.g., applied less pressure to eachof the three fingers) applied to the treatment device 106 virtually viathe master device 126.

During one or more of the modes, the one or more slave sensors 108 maymeasure force (i.e., pressure or weight) exerted by a part of the bodyof the patient. For example, the each of the one or more sections 310 ofthe treatment device 106 may contain any suitable sensor (e.g., straingauge load cell, piezoelectric crystal, hydraulic load cell, etc.) formeasuring force exerted on the treatment device 106. Further, the eachof the one or more sections 310 of the treatment device 106 may containany suitable sensor for detecting whether the body part of the patientseparates from contact with the treatment device 106. The force detectedmay be transmitted via the network interface card of the treatmentdevice 106 to the control system (e.g., slave computing device 102and/or the slave controller 118). As described further below, thecontrol system may modify a parameter of operating the slave motor 112using the measured force. Further, the control system may perform one ormore preventative actions (e.g., locking the slave motor 112 to stop thepump from activating, slowing down the slave motor 112, presenting anotification to the patient such as via the patient portal 114, etc.)when the body part is detected as separated from the treatment device106, among other things.

In some embodiments, the remote examination system 100 includes theimaging device 116. The imaging device 116 may be configured to captureand/or measure angles of extension and/or bend of body parts andtransmit the measured angles to the slave computing device 102 and/orthe master computing device 122. The imaging device 116 may be includedin an electronic device that includes the one or more processingdevices, memory devices, and/or network interface cards. The imagingdevice 116 may be disposed in a cavity of the treatment device 106(e.g., in a mechanical brace). The cavity of the mechanical brace may belocated near a center of the mechanical brace such that the mechanicalbrace affords to bend and extend. The mechanical brace may be configuredto secure to an upper body part (e.g., leg, arm, etc.) and a lower bodypart (e.g., leg, arm, etc.) to measure the angles of bend as the bodyparts are extended away from one another or retracted closer to oneanother.

The imaging device 116 can be a wearable, such as a wristband 704. Thewristband 704 may include a 2-axis accelerometer to track motion in theX, Y, and Z directions, an altimeter for measuring altitude, and/or agyroscope to measure orientation and rotation. The accelerometer,altimeter, and/or gyroscope may be operatively coupled to a processingdevice in the wristband 704 and may transmit data to the processingdevice. The processing device may cause a network interface card totransmit the data to the slave computing device 102 and the slavecomputing device 102 may use the data representing acceleration,frequency, duration, intensity, and patterns of movement to trackmeasurements taken by the patient over certain time periods (e.g., days,weeks, etc.). Executing a clinical portal 134, the slave computingdevice 102 may transmit the measurements to the master computing device122. Additionally, in some embodiments, the processing device of thewristband 704 may determine the measurements taken and transmit themeasurements to the slave computing device 102. In some embodiments, thewristband 704 may use photoplethysmography (PPG), which detects anamount of red light or green light on the skin of the wrist, to measureheart rate. For example, blood may absorb green light so that when theheart beats, the blood flow may absorb more green light, therebyenabling the detection of heart rate. The heart rate may be sent to theslave computing device 102 and/or the master computing device 122.

The slave computing device 102 may present the measurements (e.g.,measured level of force or temperature) of the body part of the patienttaken by the treatment device 106 and/or the heart rate of the patientvia a graphical indicator (e.g., a graphical element) on the patientportal 114, as discussed further below. The slave computing device 102may also use the measurements and/or the heart rate to control aparameter of operating the treatment device 106. For example, if themeasured level of force exceeds a target pressure level for anexamination session, the slave computing device 102 may control themotor 112 to reduce the pressure being applied to the treatment device106.

In some embodiments, the remote examination system 100 may include amaster computing device 122 communicatively coupled to a master console124. The master console 124 can include a master device 126. The masterdevice 126 can include a master sensor 128 and a master pressure system130. The master pressure system can include a master motor 132. Theremote examination system may also be communicatively coupled to amaster display 136. Each of the master computing device 122, the masterdevice 126, and the master display 136 may include one or moreprocessing devices, memory devices, and network interface cards. Thenetwork interface cards may enable communication via a wireless protocolfor transmitting data over short distances, such as Bluetooth, ZigBee,Near-Field Communications (NFC), etc. In some embodiments, the mastercomputing device 122 is communicatively coupled to the master device 126and the master display 136 via Bluetooth.

Additionally, the network interface cards may enable communicating dataover long distances, and in one example, the master computing device 122may communicate with a network 104. The master computing device 122 maybe communicatively coupled with the slave computing device 102 and thecloud-based computing system 142.

The master computing device 122 may be any suitable computing device,such as a laptop, tablet, smartphone, or computer. The master computingdevice 122 may include a display capable of presenting a user interface,such as a clinical portal 134. The clinical portal 134 may beimplemented in computer instructions stored on the one or more memorydevices of the master computing device 122 and executable by the one ormore processing devices of the master computing device 122. The clinicalportal 134 may present various screens to a user (e.g., a healthcareprovider), the screens configured to enable the user to view a patient'smedical records, a treatment plan, or progress during the treatmentplan; to initiate a remote examination session; to control parameters ofthe master device 126; to view progress of rehabilitation during theremote examination session, or combination thereof. The master computingdevice 122 may also include instructions stored on the one or morememory devices that, when executed by the one or more processing devicesof the master computing device 122, perform operations to control themaster device 126.

The master computing device 122 may execute the clinical portal 134. Theclinical portal 134 may be implemented in computer instructions storedon the one or more memory devices of the master computing device 122 andexecutable by the one or more processing devices of the master computingdevice 122. The clinical portal 134 may present various screens to ahealthcare provider (e.g., a clinician), the screens configured toenables the clinician to view a remote examination of a patient, such asa patient rehabilitating from a surgery (e.g., knee replacement surgery)or from an injury (e.g., sprained ankle). During a telemedicine session,an augmented image representing one or more body parts of the patientmay be presented simultaneously with a video of the patient on theclinical portal 134 in real-time or in near real-time. For example, theclinical portal 134 may, at the same time, present the augmented image402 of the knee of the patient and portions of the patient's legextending from the knee and a video of the patient's upper body (e.g.,face), so the healthcare provider can engage in more personalcommunication with the patient (e.g., via a video call). The video maybe of the patient's full body, such that, during the telemedicinesession, the healthcare provider may view the patient's entire body. Theaugmented image 402 can be displayed next to the video and/or overlaidonto the respective one or more body parts of the patient. For example,the augmented image 402 may comprise a representation of the treatmentdevice 106 coupled to the patient's knee and leg portions. The clinicalportal 134 may display the representation of the treatment device 106overlaid onto the respective one or more body parts of the patient.Real-time may refer to less than 2 seconds, or any other suitable amountof time. Near real-time may refer to 2 or more seconds. The video mayalso be accompanied by audio, text, and other multimedia information.The master display 136 may also be configured to present the augmentedimage and/or the video as described herein.

Presenting the remote examination generated by the artificialintelligence engine concurrently with a presentation of the patientvideo may provide an enhanced user interface because the healthcareprovider, while reviewing the examination on the same user interface,may also continue to visually and/or otherwise communicate with thepatient. The enhanced user interface may improve the healthcareprovider's experience in using the computing device and may encouragethe healthcare provider to reuse the user interface. Such a techniquemay also reduce computing resources (e.g., processing, memory, network),because the healthcare provider does not have to switch to another userinterface screen and, using the characteristics of the patient, enter aquery for examination guidelines to recommend. For example, the enhanceduser interface may provide the healthcare provider with recommendedprocedures to conduct during the telemedicine session. The recommendedprocedures may comprise a guide map, including indicators of locationsand measured amounts of pressure to apply on the patient's one or morebody parts. The artificial intelligence engine may analyze theexamination results (e.g., measured levels of force exerted to and bythe patient's one or more body parts, the temperature of the patient,the pain level of the patient, a measured range of motion of the one ormore body parts, etc.) and provide, dynamically on the fly, the optimalexamination procedures and excluded examination procedures.

The clinical portal 134 may also provide examination informationgenerated during the telemedicine session for the healthcare provider toview. The examination information can include a summary of theexamination and/or the results of the examination in real-time or nearreal-time, such as measured properties of the patient during theexamination. Examples of the measured properties may include, but arenot limited to, angles of bend/extension, pressure exerted on the masterdevice 126, pressure exerted by the patient on the treatment device 106,images of the examined/treated body part, and vital signs of thepatient, such as heart rate and temperature. The clinical portal 134 mayalso provide the clinician's notes and the patient's health information,such as a health history, a treatment plan, and a progress of thepatient throughout the treatment plan. So the healthcare provider maybegin the remote examination, the examination information specific tothe patient may be transmitted via the network 104 to the cloud-basedcomputing system 142 for storage and/or to the master computing device122.

In some embodiments, the clinical portal 134 may include a treatmentplan that includes one or more examination procedures (e.g.,manipulation instructions to manipulate one or more sections 210 of thetreatment device 106). For example, a healthcare provider may input, tothe clinical portal 134, a treatment plan with pre-determinedmanipulation instructions for the treatment device 106 to perform duringthe remote examination. The healthcare provider may input thepre-determined manipulation instructions prior the remote examination.The treatment device 106 can be activated to perform the manipulationsin accordance with the pre-determined manipulation instructions. Thehealthcare provider may observe the remote examination in real-time andmake modifications to the pre-determined manipulation instructionsduring the remote examination. Additionally, the system 100 can storethe results of the examination and the healthcare provider can completethe examination using the stored results (e.g., stored slave sensordata) and the master device 126. In other words, the master processingdevice can use the slave sensor data to manipulate the master device126. This manipulation of the master device 126 can allow the healthcareprovider to virtually feel the patient's one or more body parts andprovide the healthcare provider with additional information to determinea personalized treatment plan for the patient.

The master device 126 may be an examination device configured forcontrol by a healthcare provider. The master device 126 may be ajoystick, a model treatment device (e.g., a knee brace to fit over amanikin knee), an examination device to fit over a body part of thehealthcare provider (e.g., a glove device), any other suitable device,or combination thereof. The joystick may be configured to be used by ahealthcare provider to provide manipulation instructions. The joystickmay have one or more buttons (e.g., a trigger) to apply more or lesspressure to one or more sections of the treatment device 106. Thejoystick may be configured to control a moveable indicator (e.g., acursor) displayed at the master display or any other suitable display.The moveable indicator can be moved over an augmented image 400 of thetreatment device 106 and/or one or more body parts of the patient. Thehealthcare provider may be able to provide verbal commands to increaseand/or decrease pressure based on where the moveable indicator ispositioned relative to the augmented image 400. The joystick may havemaster sensors 128 within a stick of the joystick. The stick may beconfigured to provide feedback to the user (e.g., vibrations or pressureexerted by the stick to the user's hand).

The model of the treatment device may be formed similarly to thetreatment device 106. For example, if the treatment device 106 is theknee brace 202, the master device can be a model knee brace with similarcharacteristics of the knee brace 202. The model can be configured forcoupling to a manikin or any other suitable device. The model cancomprise the master pressure system 130 and master sensors 128 andfunction as described in this disclosure. The model may be configuredfor a healthcare provider to manipulate (e.g., touch, move, and/or applypressure) to one or more sections of the model and to generate mastersensor data based on such manipulations. The model can be operativelycoupled to the treatment device 106. The master sensor data can be usedto inflate and/or deflate one or more corresponding sections of thetreatment device 106 (e.g., as the healthcare provider is manipulatingthe model, the treatment device 106 is being manipulated on thepatient). Responsive to receiving the slave sensor data, the masterpressure system 130 can active and inflate and/or deflate one or moresections of the model (e.g., the pressure applied to the treatmentdevice 106 by the patient's one or more body parts is similarly appliedto the model for the healthcare provider to examine). The healthcareprovider can essentially feel, with his or her bare (or appropriatelygloved) hands, the patient's one or more body parts (e.g., the knee)while the healthcare provider virtually manipulates the patient bodypart(s).

In some embodiments, the system 100 may include one or more mastercomputing devices 122 and one or more master consoles 124. For example,a second master console can include a second master device 126operatively coupled to a second master computing device. The secondmaster device can comprise a second master pressure system 130, and,using the slave force measurements, the one or more processing devicesof system 100 can be configured to activate the second master pressuresystem 130. During and/or after a telemedicine session, one or morehealthcare providers can manipulate the treatment device 106 and/or usethe slave sensor data to virtually feel the one or more body parts ofthe patient. For example, a physician and a physical therapist mayvirtually feel the one or more body parts of the patient at the sametime or at different times. The physician may provide the manipulationinstructions and the physical therapist may observe (e.g., virtually seeand/or feel) how the patient's one or more body parts respond to themanipulations. The physician and the physical therapist may usedifferent examination techniques (e.g., locations of the manipulationsand/or measure levels of force applied to the treatment device 106) toobtain information for providing a treatment plan for the patient.Resulting from the physician using the master device 106 and thephysical therapist using the second master device, each can providemanipulation instructions to the treatment device 106. The manipulationinstructions from the master device 106 and the second master device maybe provided at the same time or at a different time (e.g., the physicianprovides a first manipulation instruction via the master device 126 andthe physical therapist provides a second manipulation instruction viathe second master device). In another example, the physician may haveinput a pre-determined manipulation instruction for the remoteexamination and the physical therapist may use the second master deviceto adjust the pre-determined manipulation instructions. The physicianand the physical therapist may be located remotely from each other (andremotely from the patient) and each can use the system 100 to examinethe patient and provide a personalized treatment plan for the patient.The system 100 can allow for collaboration between one or morehealthcare providers and provide the healthcare providers withinformation to make optimal adjustments to the patient's treatment plan.

As illustrated in FIG. 3, the master device 126 comprises a glove device300 configured to fit on a healthcare provider's hand. The glove device300 can include fingers 302. The glove may include one or more sensors(e.g., one or more master sensors 128). The glove device 300 may includethe master sensors 128 positioned along the fingers 302, 304, 306, 308,310 (collectively, fingers 302), throughout the palm of the glove, inany other suitable location, or in any combination thereof. For example,each finger can include a series of master sensors 128 positioned alongthe fingers 302. Each of the series of master sensors 128 can beoperatively coupled to one or more master controllers 138. The masterdevice 126 may include at least one or more master controllers 138 andone or more master motors 132, such as an electric motor (notillustrated).

A pump (not illustrated) may be operatively coupled to the motor. Thepump may be configured to increase or decrease pressure within themaster device 126. The master device 126 may include one or moresections and the pump can be activated to increase or decrease pressure(e.g., inflating or deflating fluid, such as water, gel, air) in the oneor more sections (e.g., one or more fingertips). One or more of thesections may include a master sensor 128. The master sensor 128 can be asensor for detecting signals, such as pressure, or any other suitablesignal. The master controller 138 may be operatively coupled to themaster motor 132 and configured to provide commands to the master motor132 to control operation of the master motor 132. The master controller138 may include any suitable microcontroller including a circuit boardhaving one or more processing devices, one or more memory devices (e.g.,read-only memory (ROM) and/or random access memory (RAM)), one or morenetwork interface cards, and/or programmable input/output peripherals.The master controller 138 may provide control signals or commands todrive the master motor 132. The master motor 132 may be powered to drivethe pump of the master device 126. The master motor 132 may provide thedriving force to the pump to increase or decrease pressure atconfigurable speeds. Further, the master device 126 may include acurrent shunt to provide resistance to dissipate energy from the mastermotor 132. In some embodiments, the treatment device 106 may comprise ahaptic system, a pneumatic system, any other suitable system, orcombination thereof. For example, the haptic system can include avirtual touch by applying forces, vibrations, or motions to thehealthcare provider through the master device 126.

The master computing device 122 may be communicatively connected to themaster device 126 via a network interface card on the master controller138. The master computing device 122 may transmit commands to the mastercontroller 138 to control the master motor 132. The network interfacecard of the master controller 138 may receive the commands and transmitthe commands to the master controller 138 to drive the master motor 132.In this way, the master computing device 122 is operatively coupled tothe master motor 132.

The master computing device 122 and/or the master controller 138 may bereferred to as a control system (e.g., a master control system) herein.The clinical portal 134 may be referred to as a clinical user interfaceof the control system. The master control system may control the mastermotor 132 to operate in a number of modes, including: standby, inflate,and deflate. The standby mode may refer to the master motor 132 poweringoff so that it does not provide any driving force to the one or morepumps. For example, when the healthcare provider is not touching anaugmented image of the treatment device 106, the pump of the masterdevice 126 may not receive instructions to inflate or deflate one ormore sections of the master device 126 and the master motor 132 mayremain turned off. In the standby mode, the master device 126 may notapply pressure to the healthcare provider's body part(s) (e.g., to thehealthcare provider's finger 304 via the glove device 300) because thehealthcare provider is not in virtual contact with the treatment device106. Furthermore, in standby mode, the master device 126 may nottransmit the master sensor data based on manipulations of the masterdevice 126 (e.g., pressure virtually exerted from the healthcare careprovider's hand to the master device 126) to the patient via thetreatment device 106.

The inflate mode may refer to the master motor 132 receiving slavesensor data comprising measurements of pressure, causing the mastermotor 132 to drive the one or more pumps coupled to the one or moresections of the master device 126 (e.g., one or more fingers 302, 304,406, 308, 310) to inflate the one or more sections. The slave sensordata may be provided by the one or more slave sensors 108 of thetreatment device 106 via the slave computing device 102. For example, asthe healthcare provider manipulates (e.g., moves) the master device 126to virtually contact one or more body parts of the patient using thetreatment device 106 in contact with the patient's one or more bodyparts, the treatment device 106 is manipulated. The slave sensors 108are configured to detect the manipulation of the treatment device 106.The detected information may include how the patient's one or more bodyparts respond to the manipulation. The one or more slave sensors 108 maydetect that one area of the patient's body part exerts a first measuredlevel of force and that another area of the patient's body part exerts asecond measured level of force (e.g., the one area may be swollen orinconsistent with baseline measurements or expectations as compared tothe other area). The master computing device 122 can receive theinformation from the slave sensor data and instruct the master motor 132to drive the pump to inflate one or more sections of the master device126. The level of inflation of the one or more sections of the masterdevice 126 may correlate with one or more measured levels of forcedetected by the treatment device 106. The slave sensor data may includea pressure gradient. The master computing device 122 may instruct themaster pressure system 130 to inflate a first section (e.g., thefingertips of the first finger 302) associated with the first measuredlevel of force exerted from a left side of the knee brace 202. Themaster computing device 122 may instruct the master pressure system 130to inflate second and third sections (e.g., the fingertips of second andthird fingers 304, 306) associated with second and third measured levelsof force exerted from a front side of the knee brace 202. In otherwords, in response to the master device 126 virtually touching thetreatment device 106, the first measured level of force may correlatewith the amount of pressure applied to the healthcare provider's firstfinger through the first finger 302 of the master device 126. Similarly,the second measured level of force may correlate with the amount ofmeasured force applied by the healthcare provider's second fingerthrough the second finger 304 of the master device 126. The thirdmeasured level of force may correlate with the amount of measured forceapplied by the healthcare provider's third finger through the thirdfinger 306 of the master device 126. The glove device 300 can include afourth finger 308 to provide a fourth measured level of force, a fifthfinger 310 to provide a fifth measured level of force, and/or othersections, such as a palm, or any combination thereof configured toprovide measured levels of force to the healthcare provider. Thesections of the glove device 300 can be inflated or deflated tocorrelate with the same and/or different levels of measured forceexerted on the treatment device 106.

The deflation mode may refer to the master motor 132 receiving slavesensor data comprising measurements of pressure, causing the mastermotor 132 to drive the one or more pumps coupled to the one or moresections of the master device 126 (e.g., one or more fingers 302) todeflate the one or more sections. The deflation mode of the masterpressure system 130 can function similarly as the inflation mode;however, in the deflation mode, the master pressure system 130 deflates,rather than inflates, the one or more sections of the master device 126.For example, the one or more slave sensors 108 may detect that one areaof the patient's body part exerts a first measured level of force andthat another area of the patient's body part exerts a second measuredlevel of force (e.g., the one area may be less swollen or lessinconsistent with baseline measurements or expectations as compared tothe other area). The master computing device 122 can receive theinformation from the slave sensor data and instruct the master motor 132to drive the pump to deflate one or more sections of the master device126. The level of deflation of the one or more sections of the masterdevice 126 may correlate with one or more measured levels of forcedetected by the treatment device 106.

The measured levels of force can be transmitted between the treatmentdevice 106 and the master device 126 in real-time, near real-time,and/or at a later time. Accordingly, the healthcare provider can use themaster device 126 to virtually examine the patient's body part byapplying the healthcare provider's hand to the master device 126, suchthat the healthcare provider's hand can, by means of the signalsreceived by the master device 126 from the treatment device 106,virtually feel, palpate or otherwise sense one or more aspects of thepatient's body part (e.g., the pressure, etc.). Similarly, the patientcan feel the healthcare provider virtually touching his or her body part(e.g., from the pressure exerted by the treatment device 106). Duringthe telemedicine session, the patient, via the patient portal 114, cancommunicate to the healthcare provider via the clinical portal 134. Forexample, during the remote examination, the patient can inform thehealthcare provider that the location of the body part that thehealthcare provider is virtually touching (e.g., manipulating) ispainful. The information can be communicated verbally and/or visually(e.g., input into the patient portal 114 directly by the client andtransmitted to the clinical portal 134 and/or the master display 136).The healthcare provider can receive additional information, such astemperature of the patient's body part, vital signs of the patient, anyother suitable information, or any combination thereof

During one or more of the inflation and deflation modes, the one or moremaster sensors 128 may measure force (i.e., pressure) exerted by thehealthcare provider via the master device 126. For example, one or moresections of the master device 126 may contain any suitable sensor (e.g.,strain gauge load cell, piezoelectric crystal, hydraulic load cell,etc.) for measuring force exerted on the master device 126. Further,each section 310 of the master device 126 may contain any suitablesensor for detecting whether the body part of the healthcare providerseparates from contact with the master device 126. The measured level(s)of force detected may be transmitted via the network interface card ofthe master device 126 to the control system (e.g., master computingdevice 122 and/or the master controller 138). As described furtherbelow, using the measured level(s) of force, the control system maymodify a parameter of operating the master motor 132. Further, thecontrol system may perform one or more preventative actions (e.g.,locking the master motor 132 to stop the pump from activating, slowingdown the master motor 132, or presenting a notification to thehealthcare provider (such as via the clinical portal 134, etc.)) whenthe body part is detected as being separated from the master device 126,among other things.

In some embodiments, the remote examination system 100 includes themaster display 136. The master console 124 and/or the clinical portal134 may comprise the master display 136. The master display 136 may beconfigured to display the treatment device 106 and/or one or more bodyparts of a patient. For example, the slave computing device 102 may beoperatively coupled to an imaging device 116 (e.g., a camera or anyother suitable audiovisual device) and/or other sensorial or perceptive(e.g., tactile, gustatory, haptic, pressure-sensing-based orelectromagnetic (e.g., neurostimulation) communication devices. Anyreference herein to any particular sensorial modality shall beunderstood to include and to disclose by implication a different one ormore sensory modalities. The slave computing device 102 can transmit,via the network 104, real images and/or a real live-streaming video ofthe treatment device 106 and/or the patient, to the master display 136.The real images and/or real video may include angles of extension and/orbend of body parts of the patient, or any other suitable characteristicsof the patient. The treatment device 106 may be operatively coupled to amedical device, such as a goniometer 702. The goniometer 702 may detectangles of extension and/or bend of body parts of the patient andtransmit the measured angles to the slave computing device 102 and/orthe treatment device 106. The slave computing device 102 can transmitthe measured angles to the master computing device 122, to the masterdisplay 136, or any other suitable device. The master display 136 candisplay the measured angles in numerical format, as an overlay image onthe image of the treatment device 106 and/or the patient's one or morebody parts, any other suitable format, or combination thereof. Forexample, as illustrated in FIG. 4A, body parts (e.g., a leg and a knee)are extended at a first angle. In FIG. 4B, the body parts areillustrated as being extended at a second angle. The master display 136may be included in an electronic device that includes the one or moreprocessing devices, memory devices, and/or network interface cards.

Depending on what result is desired, the master computing device 122and/or a training engine 146 may be trained to output a guide map. Theguide map may be overlaid on the augmented image 400. The guide map mayinclude one or more indicators. To guide the master device 126, theindicators can be positioned over one or more sections 310 of theaugmented image 400 of the treatment device 106. For example, theaugmented image 402 may include a first indicator (e.g., dotted lines inthe shape of a fingertip) positioned over a top portion of patient'sknee and a second indicator positioned over a left side of the patient'sknee. The first indicator is a guide for the healthcare provider toplace the first finger 302 on the first indicator and the second finger304 on the second indicator. The guide map may comprise a pressuregradient map. The pressure gradient map can include the current measuredlevels of force at the location of the indicator and/or a desiredmeasured level of force at the location of the indicator. For example,the first indicator may comprise a first color, a first size, or anyother suitable characteristic to indicate a first measured level offorce. The second indicator may comprise a second color, a second size,or any other suitable characteristic to indicate a second measured levelof force. When the master device 126 reaches the desired measured levelsof force, an alert may be provided. The alert may be a visual, audioand/or another alert. For example, the alert may comprise the indicatorchanging colors when the measured level of force is provided. The guidemap may include one or more configurations using characteristics of theinjury, the patient, the treatment plan, the recovery results, theexamination results, any other suitable factors, or combination thereof.One or more configurations may be displayed during the remoteexamination portion of a telemedicine session.

The master computing device 122 and/or the training engine 146 mayinclude one or more thresholds, such as pressure thresholds. The one ormore pressure thresholds may be based on characteristics of the injury,the patient, the treatment plan, the recovery results, the examinationresults, the pain level, any other suitable factors, or combinationthereof. For example, one pressure threshold pertaining to the painlevel of the patient may include a pressure threshold level for theslave pressure system 110 not to inflate a particular section 210 morethan a first measured level of force. As the pain level of the patientdecreases, the pressure threshold may change such that a second measuredlevel of force may be applied to that particular section 210. In thiscase, the patient's decreased pain level may, for more optimalexamination results (e.g., the second measured level of force is greaterthan the first measured level of force), allow for the healthcareprovider to increase the measured amount of pressure applied to thepatient's body part. Similarly, the master computing device 122 and/orthe training engine 146 may be configured to adjust any pre-determinedmanipulation instructions. In this way, the manipulation instructionscan be adapted to the specific patient.

In other embodiments, the master display 136 can display an augmentedimage (e.g., exemplary augmented images 400 illustrated in FIG. 4), anaugmented live-streaming video, a holographic image, any other suitabletransmission, or any combination thereof of the treatment device 106and/or one or more body parts of the patient. For example, the masterdisplay 136 may project an augmented image 402 representing thetreatment device 106 (e.g., a knee brace 202). The augmented image 402can include a representation 410 of the knee brace 202. The augmentedimage 402 can include a representation 412 of one or more body parts ofa patient. Using the master device 126, the healthcare provider canplace a hand on the image and manipulate the image (e.g., apply pressurevirtually to one or more sections of the patient's knee via thetreatment device 106. The one or more processing devices may cause anetwork interface card to transmit the data to the master computingdevice 122 and the master computing device 122 may use the datarepresenting pressure, temperature, and patterns of movement to trackmeasurements taken by the patient's recovery over certain time periods(e.g., days, weeks, etc.). In FIG. 4, the augmented images 400 are twodimensional, but the augmented images 400 may be transmitted asthree-dimensional images or as any other suitable image dimensionality.

The master display 136 can be configured to display information obtainedfrom a wearable, such as the wristband 704. The information may includemotion measurements of the treatment device 106 in the X, Y, and Zdirections, altitude measurements, orientation measurements, rotationmeasurements, any other suitable measurements, or combination thereof.The wristband 704 may be operatively coupled to an accelerometer, analtimeter, and/or a gyroscope. The accelerometer, the altimeter, and/orthe gyroscope may be operatively coupled to a processing device in thewristband 704 and may transmit data to the one or more processingdevices. The one or more processing devices may cause a networkinterface card to transmit the data to the master computing device 122and the master computing device 122 may use the data representingacceleration, frequency, duration, intensity, and patterns of movementto track measurements taken by the patient over certain time periods(e.g., days, weeks, etc.). Executing the clinical portal 134, the mastercomputing device 122 may transmit the measurements to the master display136. Additionally, in some embodiments, the processing device of thewristband 704 may determine the measurements taken and transmit themeasurements to the slave computing device 102. The measurements may bedisplayed on the patient portal 114. In some embodiments, the wristband704 may measure heart rate by using photoplethysmography (PPG), whichdetects an amount of red light or green light on the skin of the wrist.For example, blood may absorb green light so when the heart beats, theblood volume flow may absorb more green light, thereby enabling heartrate detection. In some embodiments, the wristband 704 may be configuredto detect temperature of the patient. The heart rate, temperature, anyother suitable measurement, or any combination thereof may be sent tothe master computing device 122.

The master computing device 122 may present the measurements (e.g.,pressure or temperature) of the body part of the patient taken by thetreatment device 106 and/or the heart rate of the patient via agraphical indicator (e.g., a graphical element) on the clinical portal134. The measurements may be presented as a gradient map, such as apressure gradient map or a temperature gradient map. The map may beoverlaid over the image of the treatment device 106 and/or the image ofthe patient's body part. For example, FIG. 4C illustrates an exemplaryaugmented image 406 displaying a pressure gradient 414 over the image ofthe patient's body parts 412 (e.g., feet). FIG. 4D illustrates anexemplary augmented image 408 displaying a temperature gradient 416 overthe image of the patient's body parts 412 (e.g., feet).

Referring back to FIG. 1, the remote examination system 100 may includea cloud-based computing system 142. In some embodiments, the cloud-basedcomputing system 142 may include one or more servers 144 that form adistributed computing architecture. Each of the servers 144 may includeone or more processing devices, memory devices, data storage devices,and/or network interface cards. The servers 144 may be in communicationwith one another via any suitable communication protocol. The servers144 may store profiles for each of the users (e.g., patients) configuredto use the treatment device 106. The profiles may include informationabout the users such as a treatment plan, the affected body part, anyprocedure the user had had performed on the affected body part, health,age, race, measured data from the imaging device 116, slave sensor data,measured data from the wristband 704, measured data from the goniometer702, user input received at the patient portal 114 during thetelemedicine session, a level of discomfort the user experienced beforeand after the remote examination, before and after remote examinationimages of the affected body part(s), and so forth.

In some embodiments, the cloud-based computing system 142 may include atraining engine 146 capable of generating one or more machine learningmodels 148. The machine learning models 148 may be trained to generatetreatment plans, procedures for the remote examination, or any othersuitable medical procedure for the patient in response to receivingvarious inputs (e.g., a procedure via a remote examination performed onthe patient, an affected body part the procedure was performed on, otherhealth characteristics (age, race, fitness level, etc.)). The one ormore machine learning models 148 may be generated by the training engine146 and may be implemented in computer instructions executable by one ormore processing devices of the training engine 146 and/or the servers144.

To generate the one or more machine learning models 148, the trainingengine 146 may train the one or more machine learning models 148. Thetraining engine 146 may use a base data set of patient characteristics,results of remote examination(s), treatment plans followed by thepatient, and results of the treatment plan followed by the patients. Theresults may include information indicating whether the remoteexamination led to an identification of the affected body part andwhether the identification led to a partial recovery of the affectedbody part or lack of recovery of the affected body part. The results mayinclude information indicating the measured levels of force applied tothe one or more sections of the treatment device 106.

The training engine 146 may be a rackmount server, a router computer, apersonal computer, an Internet of Things (IoT) device, a portabledigital assistant, a smartphone, a laptop computer, a tablet computer, acamera, a video camera, a netbook, a desktop computer, a media center,any other desired computing device, or any combination of the above. Thetraining engine 146 may be cloud-based or a real-time software platform,and it may include privacy software or protocols, and/or securitysoftware or protocols.

The one or more machine learning models 148 may also be trained totranslate characteristics of patients received in real-time (e.g., froman electronic medical records (EMR) system, from the slave sensor data,etc.). The one or more machine learning models 148 may refer to modelartifacts that are created by the training engine 146 using trainingdata that includes training inputs and corresponding target outputs. Thetraining engine 146 may find patterns in the training data that map thetraining input to the target output, and generate the machine learningmodels 148 that capture these patterns. Although depicted separatelyfrom the slave computing device 102, in some embodiments, the trainingengine 146 and/or the machine learning models 148 may reside on theslave computing device 102 and/or the master computing device 122.

Different machine learning models 148 may be trained to recommenddifferent optimal examination procedures for different desired results.For example, one machine learning model may be trained to recommendoptimal pressure maps for most effective examination of a patient, whileanother machine learning model may be trained to recommend optimalpressure maps using the current pain level and/or pain level toleranceof a patient.

The machine learning models 148 may include one or more of a neuralnetwork, such as an image classifier, recurrent neural network,convolutional network, generative adversarial network, a fully connectedneural network, or some combination thereof, for example. In someembodiments, the machine learning models 148 may be composed of a singlelevel of linear or non-linear operations or may include multiple levelsof non-linear operations. For example, the machine learning model mayinclude numerous layers and/or hidden layers that perform calculations(e.g., dot products) using various neurons.

FIGS. 1-4 are not intended to be limiting: the remote examination system100 may include more or fewer components than those illustrated in FIGS.1-4.

FIG. 5 illustrates a computer-implemented method 500 for remoteexamination. The method 500 may be performed by the remote examinationsystem 100, such as at a master processing device. The processing deviceis described in more detail in FIG. 6. The steps of the method 500 maybe stored in a non-transient computer-readable storage medium.

At step 502, the method 500 includes the master processing devicereceiving slave sensor data from one or more slave sensors 108. Themaster processing device may receive, via the network 104, the slavesensor data from a slave processing device.

At step 504, the master processing device can transmit an augmentedimage 400. The augmented image 400 may be based on the slave sensordata.

At step 506, the master processing device receives master sensor dataassociated with a manipulation of the master device 126. For example,the master sensor data may include a measured level of force that theuser, such as a healthcare provider, applied to the master device 126.

At step 508, the master processing device can generate a manipulationinstruction. The manipulation instruction is based on the master sensordata associated with the manipulation of the master device 126.

At step 510, the master processing device transmits the manipulationinstruction. The master processing device may transmit, via the network104, the manipulation instruction to the slave computing device 102.

At step 512, the master processing device causes the slave pressuresystem to activate. Using the manipulation instruction, the slavecomputing device 102 can cause the treatment device 106 to activate theslave pressure system 110. For example, responsive to the manipulationinstruction (e.g., to increase and/or decrease one or more measuredlevels of force in one or more sections of the treatment device), theslave pressure system 110 can cause the slave controller 118 to activatethe slave motor 112 to inflate and/or deflate the one or more sections210 to one or more measured levels of force.

At step 514, the master processing device receives slave forcemeasurements. The slave force measurements can include one or moremeasurements associated with one or more measured levels of force thatthe patient's body is applying to the treatment device 106.

At step 516, the master processing device uses the pressure slavemeasurements to activate the master pressure system 130. For example,the master pressure system 130 can cause the master device 126 toinflate and/or deflate one or more sections 310 of the master device 126such that the measured levels of force of the one or more sections 310directly correlate with the one or more measured levels of force thatthe patient's body is applying to the one or more sections 210 of thetreatment device 106.

FIG. 6 illustrates a computer-implemented method 600 for remoteexamination. The method 600 may be performed by the remote examinationsystem 100, such as at a slave processing device. The processing deviceis described in more detail in FIG. 6. The steps of the method 600 maybe stored in a non-transient computer-readable storage medium.

At step 602, the method 600 includes the slave processing devicereceiving slave sensor data from one or more slave sensors 108. The oneor more slave sensors 108 may include one or more measured levels offorce that the patient's body is applying to the treatment device 106.

At step 604, the slave processing device transmits the slave sensordata. The slave processing device may transmit, via the network 104, theslave sensor data to the master computing device 122.

At step 606, the slave processing device may transmit an augmented image400. The augmented image 400 is based on the slave sensor data. Forexample, the augmented image 400 may include a representation of thetreatment device 106, one or more body parts of the patient, measuredlevels of force, measured levels of temperature, any other suitableinformation, or combination thereof.

At step 608, the slave processing device receives a manipulationinstruction. The manipulation instruction can be generated based on themaster sensor data.

At step 610, using the manipulation instruction, the slave processingdevice activates the slave pressure system 110. For example, themanipulation instruction may cause the slave pressure system 110 toinflate and/or deflate one or more sections 210 of the treatment device106 to correlate with one or more levels of force applied to one or moresections 310 of the master device 126.

At step 612, the slave processing device receives slave forcemeasurements. The slave force measurements can include one or moremeasured levels of force exerted by the patient's body to the treatmentdevice 106.

At step 614, the slave processing device transmits the slave forcemeasurements, such as to the master processing device.

At step 616, using the slave force measurements, the slave processingdevice causes a master pressure system 130 to activate. For example, themaster pressure system 130 can cause the master device 126 to inflateand/or deflate one or more sections 310 of the master device 126 suchthat the measured levels of force of the one or more sections 310correlate with the one or more measured levels of force that thepatient's body is applying to the one or more sections 210 of thetreatment device 106.

FIGS. 5-6 are not intended to be limiting: the methods 500, 600 caninclude more or fewer steps and/or processes than those illustrated inFIGS. 5-6. Further, the order of the steps of the methods 500, 600 isnot intended to be limiting; the steps can be arranged in any suitableorder. Any or all of the steps of methods 500,600 may be implementedduring a telemedicine session or at any other desired time.

FIG. 7 illustrates a high-level component diagram of an illustrativearchitecture of system 700 for enabling remote adjustment of a device,such as during a telemedicine session, according to certain aspects ofthis disclosure. The system 700 may include one or more components ofFIG. 1 that have been described above. Any component or combination ofthe components illustrated in the system 700 may be included in and/orused in connection with the examination system 100. The system 100and/or the system 700 is not limited to use in the medical field.

In some embodiments, the system 700 may include a slave computing device102 communicatively coupled to a treatment device 800, such as anelectromechanical device 802, a goniometer 702, a wristband 810, and/orpedals 810 of the electromechanical device 802. Each of the computingdevice 102, the electromechanical device 802, the goniometer 702, thewristband 810, and the pedals 810 may include one or more processingdevices, memory devices, and network interface cards. The networkinterface cards may enable communication via a wireless protocol fortransmitting data over short distances, such as Bluetooth, ZigBee, etc.In some embodiments, the computing device 102 is communicatively coupledto the electromechanical device 802, goniometer 702, the wristband 810,and/or the pedals 810 via Bluetooth.

The patient portal 114 may present various screens to a user that enablethe user to view a treatment plan, initiate a pedaling session of thetreatment plan, control parameters of the electromechanical device 802,view progress of rehabilitation during the pedaling session, and soforth as described in more detail below. The computing device 102 mayalso include instructions stored on the one or more memory devices that,when executed by the one or more processing devices of the computingdevice 102, perform operations to control the electromechanical device802.

The clinical portal 134 may present various screens to a healthcareprovider, such as a physician that enable the physician to create atreatment plan for a patient, view progress of the user throughout thetreatment plan, view measured properties (e.g., angles ofbend/extension, force exerted on pedals 810, heart rate, steps taken,images of the affected body part) of the user during sessions of thetreatment plan, view properties (e.g., modes completed, revolutions perminute, etc.) of the electromechanical device 802 during sessions of thetreatment plan. The treatment plan specific to a patient may betransmitted via the network 104 to the cloud-based computing system 142for storage and/or to the computing device 102 so the patient may beginthe treatment plan. The healthcare provider can adjust the treatmentplan during a session of the treatment plan in real-time or nearreal-time. For example, the healthcare provider may be monitoring thepatient while the patient is using the electromechanical device 802 and,by using the measured properties, the healthcare provider may adjust thetreatment plan and transmit the adjusted treatment plan to control atleast one operation of the electromechanical device 802. The treatmentplan and/or an adjusted treatment plan can include parameters foroperation of the electromechanical device 802. If the patient isoperating the electromechanical device 802 such that the operations arenot within the parameters, a trigger condition may occur, and may bedetected or enabled to be detected. In any of the forgoing cases, theone or more processors can control at least one operation of theelectromechanical device 102. The automated control can function as asafety feature for the patient as the control mitigates the patient'srisk of further injury.

The electromechanical device 802 may be an adjustable pedaling devicefor exercising, strengthening, and rehabilitating arms and/or legs of auser. The electromechanical device 802 may include at least one or moremotor controllers 804, one or more electric motors 806, and one or moreradially-adjustable couplings 808. Two pedals 810 may be coupled to tworadially-adjustable couplings 808 via left and right pedal assembliesthat each include respective stepper motors. The motor controller 804may be operatively coupled to the electric motor 806 and configured toprovide commands to the electric motor 806 to control operation of theelectric motor 806. The motor controller 804 may include any suitablemicrocontroller including a circuit board having one or more processingdevices, one or more memory devices (e.g., read-only memory (ROM) and/orrandom access memory (RAM)), one or more network interface cards, and/orprogrammable input/output peripherals. The motor controller 804 mayprovide control signals or commands to drive the electric motor 806. Theelectric motor 806 may be powered to drive one or moreradially-adjustable couplings 808 of the electromechanical device 802 ina rotational manner. The electric motor 806 may provide the drivingforce to rotate the radially-adjustable couplings 808 at configurablespeeds. The couplings 808 are radially-adjustable in that a pedal 810attached to the coupling 808 may be adjusted to a number of positions onthe coupling 808 in a radial fashion. Further, the electromechanicaldevice 802 may include current shunt to provide resistance to dissipateenergy from the electric motor 806. As such, the electric motor 806 maybe configured to provide resistance to rotation of theradially-adjustable couplings 808.

The computing device 102 may be communicatively connected to theelectromechanical device 802 via the network interface card on the motorcontroller 804. The computing device 102 may transmit commands to themotor controller 804 to control the electric motor 806. The networkinterface card of the motor controller 804 may receive the commands andtransmit the commands to the electric motor 806 to drive the electricmotor 806. In this way, the computing device 102 is operatively coupledto the electric motor 806.

The computing device 102 and/or the motor controller 804 may be referredto as a control system herein. The patient portal 114 may be referred toas a user interface of the control system herein. The control system maycontrol the electric motor 806 to operate in a number of modes: passive,active-assisted, resistive, and active. The passive mode may refer tothe electric motor 806 independently driving the one or moreradially-adjustable couplings 808 rotationally coupled to the one ormore pedals 810. In the passive mode, the electric motor 806 may be theonly source of driving force on the radially-adjustable couplings. Thatis, the user may engage the pedals 810 with their hands or their feetand the electric motor 806 may rotate the radially-adjustable couplings808 for the user. This may enable moving the affected body part andstretching the affected body part without the user exerting excessiveforce.

The active-assisted mode may refer to the electric motor 806 receivingmeasurements of revolutions per minute of the one or moreradially-adjustable couplings 808, and causing the electric motor 806 todrive the one or more radially-adjustable couplings 808 rotationallycoupled to the one or more pedals 810 when the measured revolutions perminute satisfy a parameter (e.g., a threshold condition). The thresholdcondition may be configurable by the user and/or the physician. Theelectric motor 806 may be powered off while the user provides thedriving force to the radially-adjustable couplings 808 as long as therevolutions per minute are above a revolutions per minute threshold andthe threshold condition is not satisfied. When the revolutions perminute are less than the revolutions per minute threshold then thethreshold condition is satisfied and the electric motor 806 may becontrolled to drive the radially-adjustable couplings 808 to maintainthe revolutions per minute threshold.

The resistive mode may refer to the electric motor 806 providingresistance to rotation of the one or more radially-adjustable couplings808 coupled to the one or more pedals 810. The resistive mode mayincrease the strength of the body part being rehabilitated by causingthe muscle to exert force to move the pedals against the resistanceprovided by the electric motor 806.

The active mode may refer to the electric motor 806 powering off toprovide no driving force assistance to the radially-adjustable couplings808. Instead, in this mode, the user provides the sole driving force ofthe radially-adjustable couplings using their hands or feet, forexample.

During one or more of the modes, each of the pedals 810 may measureforce exerted by a part of the body of the user on the pedal 810. Forexample, the pedals 810 may each contain any suitable sensor (e.g.,strain gauge load cell, piezoelectric crystal, hydraulic load cell,etc.) for measuring force exerted on the pedal 810. Further, the pedals810 may each contain any suitable sensor for detecting whether the bodypart of the user separates from contact with the pedals 810. In someembodiments, the measured force may be used to detect whether the bodypart has separated from the pedals 810. The force detected may betransmitted via the network interface card of the pedal 810 to thecontrol system (e.g., computing device 102 and/or motor controller 804).As described further below, the control system may modify a parameter ofoperating the electric motor 806 based on the measured force. Further,the control system may perform one or more preventative actions (e.g.,locking the electric motor 120 to stop the radially-adjustable couplings808 from moving, slowing down the electric motor 806, presenting anotification to the user, etc.) when the body part is detected asseparated from the pedals 810, among other things.

The goniometer 702 may be configured to measure angles of extensionand/or bend of body parts and transmit the measured angles to thecomputing device 102 and/or the computing device 134. The goniometer 702may be included in an electronic device that includes the one or moreprocessing devices, memory devices, and/or network interface cards. Thegoniometer 702 may be disposed in a cavity of a mechanical brace. Thecavity of the mechanical brace may be located near a center of themechanical brace where the mechanical brace affords to bend and extend.The mechanical brace may be configured to secure to an upper body part(e.g., arm, etc.) and a lower body part (e.g., leg, etc.) to measure theangles of bend as the body parts are extended away from one another orretracted closer to one another.

The wristband 810 may include a 3-axis accelerometer to track motion inthe X, Y, and Z directions, an altimeter for measuring altitude, and/ora gyroscope to measure orientation and rotation. The accelerometer,altimeter, and/or gyroscope may be operatively coupled to a processingdevice in the wristband 810 and may transmit data to the processingdevice. The processing device may cause a network interface card totransmit the data to the computing device 102 and the computing device102 may use the data representing acceleration, frequency, duration,intensity, and patterns of movement to track steps taken by the userover certain time periods (e.g., days, weeks, etc.). The computingdevice 102 may transmit the steps to the master computing device 134executing a clinical portal 134. Additionally, in some embodiments, theprocessing device of the wristband 810 may determine the steps taken andtransmit the steps to the computing device 102. In some embodiments, thewristband 810 may use photoplethysmography (PPG) to measure heart ratethat detects an amount of red light or green light on the skin of thewrist. For example, blood may absorb green light so when the heartbeats, the blood flow may absorb more green light, thereby enablingdetecting heart rate. The heart rate may be sent to the computing device102 and/or the computing device 134.

The computing device 102 may present the steps taken by the user and/orthe heart rate via respective graphical element on the patient portal114, as discussed further below. The computing device may also use thesteps taken and/or the heart rate to control a parameter of operatingthe electromechanical device 802. For example, if the heart rate exceedsa target heart rate for a pedaling session, the computing device 102 maycontrol the electric motor 806 to reduce resistance being applied torotation of the radially-adjustable couplings 808. In another example,if the steps taken are below a step threshold for a day, the treatmentplan may increase the amount of time for one or more modes in which theuser is to operate the electromechanical device 802 to ensure theaffected body part is getting sufficient movement.

In some embodiments, the cloud-based computing system 142 may includeone or more servers 144 that form a distributed computing architecture.Each of the servers 144 may include one or more processing devices,memory devices, data storage, and/or network interface cards. Theservers 144 may be in communication with one another via any suitablecommunication protocol. The servers 144 may store profiles for each ofthe users that use the electromechanical device 802. The profiles mayinclude information about the users such as a treatment plan, theaffected body part, any procedure the user had performed on the affectedbody part, health, age, race, measured data from the goniometer 702,measured data from the wristband 810, measured data from the pedals 810,user input received at the patient portal 114 during operation of any ofthe modes of the treatment plan, a level of discomfort, comfort, orgeneral patient satisfaction that the user experiences before and afterany of the modes, before and after session images of the affected bodypart, and so forth.

In some embodiments the cloud-based computing system 142 may include atraining engine 130 that is capable of generating one or more machinelearning models 132. The one or more machine learning models 132 may begenerated by the training engine 130 and may be implemented in computerinstructions that are executable by one or more processing device of thetraining engine 130 and/or the servers 144. To generate the one or moremachine learning models 132, the training engine 130 may train the oneor more machine learning models 132. The training engine 130 may use abase data set of patient characteristics, treatment plans followed bythe patient, and results of the treatment plan followed by the patients.The results may include information indicating whether the treatmentplan led to full recovery of the affected body part, partial recovery ofthe affected body part, or lack of recovery of the affected body part.The one or more machine learning models 132 may refer to model artifactsthat are created by the training engine 130 using training data thatincludes training inputs and corresponding target outputs. The trainingengine 130 may find patterns in the training data that map the traininginput to the target output, and generate the machine learning models 132that capture these patterns. Although depicted separately from thecomputing device 102, in some embodiments, the training engine 130and/or the machine learning models 132 may reside on the computingdevice 102 and/or the computing device 134.

As illustrated in FIGS. 8 and 11-12, the treatment device 106 maycomprise an electromechanical device, such as a physical therapy device.FIG. 8 illustrates a perspective view of an example of a treatmentdevice 800 according to certain aspects of this disclosure.Specifically, the treatment device 800 illustrated is anelectromechanical device 802, such as an exercise and rehabilitationdevice (e.g., a physical therapy device or the like). Theelectromechanical device 802 is shown having pedal 810 on opposite sidesthat are adjustably positionable relative to one another on respectiveradially-adjustable couplings 808. The depicted electromechanical device802 is configured as a small and portable unit so that it is easilytransported to different locations at which rehabilitation or treatmentis to be provided, such as at patients' homes, alternative carefacilities, or the like. The patient may sit in a chair proximate theelectromechanical device 802 to engage the electromechanical device 802with the patient's feet, for example. The electromechanical device 802includes a rotary device such as radially-adjustable couplings 808 orflywheel or the like rotatably mounted such as by a central hub to aframe or other support. The pedals 810 are configured for interactingwith a patient to be rehabilitated and may be configured for use withlower body extremities such as the feet, legs, or upper bodyextremities, such as the hands, arms, and the like. For example, thepedal 810 may be a bicycle pedal of the type having a foot supportrotatably mounted onto an axle with bearings. The axle may or may nothave exposed end threads for engaging a mount on the radially-adjustablecoupling 808 to locate the pedal on the radially-adjustable coupling808. The radially-adjustable coupling 808 may include an actuatorconfigured to radially adjust the location of the pedal to variouspositions on the radially-adjustable coupling 808.

Alternatively, the radially-adjustable coupling 808 may be configured tohave both pedals 810 on opposite sides of a single coupling 808. In someembodiments, as depicted, a pair of radially-adjustable couplings 808may be spaced apart from one another but interconnected to the electricmotor 806. In the depicted example, the computing device 102 may bemounted on the frame of the electromechanical device 802 and may bedetachable and held by the user while the user operates theelectromechanical device 802. The computing device 102 may present thepatient portal 114 and control the operation of the electric motor 806,as described herein.

In some embodiments, as described in U.S. Pat. No. 10,173,094 (U.S.application Ser. No. 15/700,293), which is incorporated by referenceherein in its entirety for all purposes, the treatment device 106 maytake the form of a traditional exercise/rehabilitation device which ismore or less non-portable and remains in a fixed location, such as arehabilitation clinic or medical practice. The treatment device 106 mayinclude a seat and is less portable than the treatment device 106 shownin FIG. 8. FIG. 8 is not intended to be limiting: the treatment device800 may include more or fewer components than those illustrated in FIG.8.

FIGS. 11-12 generally illustrate an embodiment of a treatment device,such as a treatment device 10. More specifically, FIG. 11 generallyillustrates a treatment device 10 in the form of an electromechanicaldevice, such as a stationary cycling machine 14, which may be called astationary bike, for short. The stationary cycling machine 14 includes aset of pedals 12 each attached to a pedal arm 20 for rotation about anaxle 16. In some embodiments, and as generally illustrated in FIG. 11,the pedals 12 are movable on the pedal arm 20 in order to adjust a rangeof motion used by the patient in pedaling. For example, the pedals beinglocated inwardly toward the axle 16 corresponds to a smaller range ofmotion than when the pedals are located outwardly away from the axle 16.A pressure sensor 18 is attached to or embedded within one of the pedals12 for measuring an amount of force applied by the patient on the pedal102. The pressure sensor 18 may communicate wirelessly to the treatmentdevice 10 and/or to the patient interface 26. FIGS. 11-12 are notintended to be limiting: the treatment device 10 may include more orfewer components than those illustrated in FIGS. 11-12.

FIG. 13 generally illustrates a person (a patient) using the treatmentdevice of FIG. 11, wherein sensors and various data parameters areconnected to a patient interface 26. The example patient interface 26 isa tablet computer or smartphone, or a phablet, such as an iPad, aniPhone, an Android device, or a Windows device such as a Surface tablet,any of which may be held manually by the patient. In some otherembodiments, the patient interface 26 may be embedded within or attachedto the treatment device 10. FIG. 13 generally illustrates the patientwearing the ambulation sensor 22 on his wrist, with a note showing“STEPS TODAY 1355”, indicating that the ambulation sensor 22 hasrecorded and transmitted that step count to the patient interface 26.FIG. 13 also generally illustrates the patient wearing the goniometer 24on his right knee, with a note showing “KNEE ANGLE 72°”, indicating thatthe goniometer 24 is measuring and transmitting that knee angle to thepatient interface 26. FIG. 13 generally illustrates a right side of oneof the pedals 12 with a pressure sensor 18 showing “FORCE 12.5 lbs.”,indicating that the right pedal pressure sensor 18 is measuring andtransmitting that force measurement to the patient interface 26. FIG. 13also generally illustrates a left side of one of the pedals 12 with apressure sensor 18 showing “FORCE 27 lbs.”, indicating that the leftpedal pressure sensor 18 is measuring and transmitting that forcemeasurement to the patient interface 26. FIG. 13 also generallyillustrates other patient data, such as an indicator of “SESSION TIME0:04:13”, indicating that the patient has been using the treatmentdevice 10 for 4 minutes and 13 seconds. This session time may bedetermined by the patient interface 26 based on information receivedfrom the treatment device 10. FIG. 13 also generally illustrates anindicator showing “PAIN LEVEL 3”. Such a pain level may be obtained fromthe patient in response to a solicitation, such as a question, presentedupon the patient interface 26.

FIG. 9 illustrates a computer-implemented method 900 for enabling aremote adjustment of a device. The device may be a treatment device,such as the treatment device 800, the device 10, or any other desireddevice. The device may comprise at least one of a physical therapydevice (e.g., the rehabilitation device 802), a brace (e.g., the brace202), a cap (e.g., the cap 204), a mat (e.g., the mat 206), a wrap(e.g., the wrap 208), a treatment device (e.g., the treatment device 10,the treatment device 106, the stationary cycling machine 14, or thelike), any other suitable device, or combination thereof. The device maybe configured to be manipulated by a user while the user performs atreatment plan. The method 900 may be performed at a processing deviceoperatively coupled to the remote examination system 100, the system800, or any combination thereof. For example, the method may beperformed using a patient interface comprising an output deviceconfigured to present telemedicine information associated with atelemedicine session. The steps of the method 900 may be stored in anon-transient computer-readable storage medium.

A healthcare provider can use information obtained from an examinationof a patient to determine a proper treatment plan for the patient. Usingthe systems 100, 800, the healthcare provider can conduct a remotephysical examination of the one or more body parts of the patient and/orview results of an exercise, rehabilitation, or other session to providea treatment plan for the patient. For example, the healthcare providercan conduct the remote physical examination during a telemedicinesession.

At step 902, the method 900 includes receiving a treatment plan for apatient. The treatment plan can be received from a clinical portal 134.For example, the healthcare provider may input a treatment plan into theclinical portal 134, which in turn can transmit the treatment plan tothe slave computing device 102 and the treatment device 106, 800. Forexample, the transmission of the treatment plan can be transmittedduring a telemedicine session or at another desired time.

At step 904, the method 900 includes using the treatment plan togenerate at least one parameter. The at least one parameter may begenerated during a telemedicine session or at another desired time. Thetreatment plan may include a plan to treat a patient (e.g.,prehabilitation, rehabilitation, or the like). The plan may includepatient information (e.g., patient health history, characteristics of aninjury, etc.), one or more types of exercises, a schedule of when andfor how long to perform the exercises, at least one threshold that thepatient should meet and/or not exceed, any other suitable information,or combination thereof. The processing device can use the information inthe treatment plan to generate the at least one parameter. For example,the at least one parameter may be a measurable threshold or thresholdranges of data to be detected by the sensor(s) relating to the patient(e.g., pain level, vital signs, etc.) or to the operation of thetreatment device 106, 800 (e.g., volume of sections 210, revolutions perminute, angle of the pedals 810, etc.). The at least one parameter canbe at least one of a force parameter, a resistance parameter, a range ofmotion parameter, a temperature parameter, a pain level parameter, anexercise session parameter, a vital sign parameter, a time parameter,any other suitable parameter, or combination thereof. In one example,the force parameter may be based on characteristics of the injury, thepatient, the treatment plan, the recovery results, the examinationresults, the pain level, any other suitable factors, or combinationthereof. The force parameter may pertain to the pain level of thepatient and include a measured level of force for the patient to exerton the pedals 810. The resistance parameter may be a parameterpertaining to a measured amount of resistance that the motor 806 appliesto the pedals 810 during a cycling session. The range of motionparameter may be a parameter pertaining to a measured range of motion ofa patient's body part (e.g., a knee). The temperature parameter may be aparameter pertaining to a measured temperature of the patient or thepatient's body part. The pain level parameter may be a parameterpertaining to a level of pain that the patient reports or experiencesbefore, during, or after the patient uses the treatment device 800. Theexercise session parameter may be a parameter pertaining to a type ofexercise, a number of steps that the patient has taken during the dayand/or during an exercise session, or any other suitable exerciseinformation. The exercise session can include a session for any purpose,including rehabilitation, prehabilitation, exercise, strength training,endurance training, any other type of exercise, or combination thereof.The vital sign parameter may be a parameter pertaining to a measurementof the patient's heart rate, pulse rate, blood pressure, respirationrate, or any other vital sign. The time parameter may be a parameterpertaining to an amount of time (e.g., minutes) for which the patientshould engage in an exercise session, an amount of time (e.g., hours)between exercise sessions, any other suitable time measurements, orcombination thereof.

At step 906, the method 900 includes receiving data correlating with atleast one operation of the device. The data may be received during atelemedicine session or at another desired time. The device may compriseone or more sensors for detecting data correlating with the at least oneoperation. Examples of the measured properties may include, but are notlimited to, angles of bend/extension, pressure exerted on the device,the speed of rotating the device (e.g., pedaling speed), the amount ofresistance (e.g., pedal resistance), the distance the patient hastraveled (e.g., cycled, walked, etc.), the number of steps the patienthas taken, images of the examined/treated body part, and vital signs ofthe patient, such as heart rate and temperature. The data can bereceived from the one or more sensors in real-time or near real-time.

At step 908, the method 900 includes determining if a trigger conditionhas occurred. The trigger may be determined during a telemedicinesession or at another desired time. A trigger condition is a conditionthat occurs when at least one of the data, the at least one parameter, apatient input, any other suitable information, or combination thereof isoutside of the at least one parameter. Patient input may include a painlevel, a pain tolerance, a weight, or any other suitable informationfrom the patient. In one embodiment, the processing device may use themeasured heart rate to determine if the heart rate is outside of thevital sign parameter (e.g., above and/or below a heart rate threshold).In another example, the processing device may use the counted number ofsteps taken to determine if the number of steps taken is outside of theexercise session parameter (e.g., above and/or below a step threshold).If one or more measurements are outside of the respective parameters(e.g., if the patient's heart rate is above the heart rate threshold, ifthe number of steps the patient has taken during the day is below thestep threshold), a trigger condition has occurred. Patient input may bereceived during a telemedicine session or at another desired time.

At step 910, responsive to at least one trigger condition occurring, themethod 900 proceeds with controlling at least one operation of thedevice. The processing device may control the operation of the device(e.g., the treatment device 106, 800). The processing device may controlthe operation of the device during a telemedicine session or at anotherdesired time. The controlling of the at least one operation of thedevice can include causing the device to modify at least one of avolume, a pressure, a resistance, an angle, a speed, an angular orrotational velocity, and a time period. The modification may include notjust a value but also a constraint, limitation, maximum, minimum, etc.For example, if the heart rate of the patient exceeds a vital signparameter for a pedaling session, the computing device 102 may controlthe electric motor 806 to reduce the resistance being applied to therotation of the radially-adjustable couplings 808. The motor controller804 may be operatively coupled to the electric motor 806 and configuredto provide commands to the electric motor 806 to control operation ofthe electric motor 806. In another example, if a volume of a section 210of the treatment device 106 exceeds the volume parameter, the processingdevice may control the treatment device 106 to deflate the section 210to a volume within the volume parameter. In this example, if themeasured level of volume exceeds the volume parameter, the excesspressure that the treatment device 106 may be exerting on the patientmay cause the patient pain or discomfort, and thus, the processingdevice is configured to adjust the volume (e.g., decrease the volume) todecrease the pressure exerted on the patient.

At step 912, the method 900 proceeds with transmitting a notification toa clinical portal. The notification may be transmitted during atelemedicine session or at another desired time. The notification mayinclude results of an exercise session, the patient's recovery results,the vital sign(s), the pain level, input from the patient, any othersuitable information, or combination thereof. The notification can betransmitted to the clinical portal 134 in real-time, in near real-time,before or after an exercise session, at any other suitable time, orcombination thereof. The notification can assist the healthcare providerin assessing the patient's treatment plan and making any adjustments tothe treatment plan that may optimize the patient's treatment (i.e., todecrease the patient's recovery time; to increase the patient'sstrength, range of motion, and flexibility, etc.).

At step 914, the method 900 proceeds with receiving at least oneadjusted parameter. The parameter may be received during a telemedicinesession or at another desired time. The healthcare provider may inputthe at least one adjusted parameter to the clinical portal 134 fortransmitting to the patient portal 114, the treatment device 106, 800,the slave computing device 102, or any combination thereof. For example,while using the rehabilitation device 802 over the course of a few days,if the patient is not within the time parameter (e.g., not exercisingfor a long enough period of time) and if the patient's pain levelexceeds a pain level parameter, the healthcare provider may adjust thetime parameter (e.g., to decrease the amount of time for the exercise)and adjust the force parameter (e.g., to increase the level of motorassistance for a cycling exercise). Such adjustments may result inimproved patient compliance with the treatment plan and decrease thepatient's recovery time. The at least one adjusted parameter can bereceived in real-time, in near real-time, prior to an exercise session,at any other suitable time, or any combination thereof. For example, thehealthcare provider may be remotely reviewing the notification(s) inreal-time or near real-time while a patient is engaging in an exercisesession and/or after the patient has finished the exercise session. Asan example, the healthcare provider may upload the treatment plan, theadjusted treatment plan, and/or the adjusted parameter one day and thepatient may use the device at a later time, such as later in the day,the following morning, the following day, or the following week, etc.

In another embodiment, the method 900 receives an adjusted treatmentplan, such as from the clinical portal 134. The adjusted treatment planmay be received during a telemedicine session or at another desiredtime. The adjusted treatment plan may include at least some differentinformation from the treatment plan. For example, the doctor may haveused the notification, client input, results from the exercise session,any other suitable information, or combination thereof to make a changeto the treatment plan. The processing device may use the adjustedtreatment plan to generate an adjusted parameter.

At step 916, the method 900 proceeds with using the at least oneadjusted parameter to control the at least one operation of the device.The at least one adjusted parameter may be used to control the at leastone operation of the device during a telemedicine session or at anotherdesired time. In one example, if the steps taken by a patient are belowan exercise session parameter (e.g., a step threshold for a day), theexercise session parameter may be adjusted to increase the amount oftime for one or more modes in which the patient is to operate theelectromechanical device 802 to ensure the affected body part is gettingsufficient movement. The at least one adjusted parameter can be used inreal-time or near real-time to control the at least one operation of thedevice. For example, if the healthcare provider is remotely observingthe patient during the exercise session (e.g., reviewing the results ofthe exercise session, notifications, etc.) and provides an adjustedparameter while the patient is using the device, the at least oneoperation of the electromechanical device 802 can be adjusted inreal-time or near real-time (e.g., providing motor assist while thepatient is cycling). The at least one adjusted parameter can be receivedprior to the patient operating the device to control the at least oneoperation of the device at a time subsequent to receiving the at leastone adjusted parameter. For example, the healthcare provider maydetermine that the patient is recovering and adjust one or moreparameters (e.g., increase motor resistance on the pedals 810) toincrease the intensity of the workout so that the patient can rebuildmuscle strength and recover more quickly.

FIG. 9 is not intended to be limiting: the method 900 can include moreor fewer steps and/or processes than those illustrated in FIG. 9.Further, the order of the steps of the method 900 is not intended to belimiting; the steps can be arranged in any suitable order.

FIG. 10 illustrates, in accordance with one or more aspects of thepresent disclosure, an example computer system 1000 which can performany one or more of the methods described herein. The computer system1000 may correspond to the slave computing device 102 (e.g., a patient'scomputing device), the master computing device 122 (e.g., a healthcareprovider's computing device), one or more servers of the cloud-basedcomputing system 142, the training engine 146, the server 144, the slavepressure system 110, the master pressure system 130, the slavecontroller 118, the master controller 138, the imaging device 116, themaster display 136, the treatment device 106, the master device 126, themaster console 124, the treatment device 800, the motor controller 804,the electric motor 806, the radially-adjustable couplings 808, thepedals 810, the goniometer 702, and/or the wristband 704 illustrated inFIGS. 1 and/or 7. The computer system 1000 may be capable of executingthe patient portal 114 and/or clinical portal 134 of FIGS. 1 and 7. Thecomputer system 1000 may be connected (e.g., networked) to othercomputer systems in a LAN, an intranet, an extranet, or the Internet.The computer system 1000 may operate in the capacity of a server in aclient-server network environment. The computer system may be a personalcomputer (PC), a tablet computer, a motor controller, a goniometer(e.g., the goniometer 702), a wearable (e.g., the wristband 704), aset-top box (STB), a personal Digital Assistant (PDA), a mobile phone, acamera, a video camera, or any device capable of executing a set ofinstructions (sequential or otherwise) that specify actions to be takenby that device. Further, while only a single computer system isillustrated, the term “computer” shall also be taken to include anycollection of computers that individually or jointly execute a set (ormultiple sets) of instructions to perform any one or more of the methodsdiscussed herein.

The computer system 1000 includes a processing device 1002 (e.g., theslave processing device, the master processing device), a main memory1004 (e.g., read-only memory (ROM), flash memory, dynamic random accessmemory (DRAM) such as synchronous DRAM (SDRAM)), a static memory 1006(e.g., flash memory, static random access memory (SRAM)), and a datastorage device 1008, which communicate with each other via a bus 1010.

The processing device 1002 represents one or more general-purposeprocessing devices such as a microprocessor, central processing unit, orthe like. More particularly, the processing device 1002 may be a complexinstruction set computing (CISC) microprocessor, reduced instruction setcomputing (RISC) microprocessor, very long instruction word (VLIW)microprocessor, or a processor implementing other instruction sets orprocessors implementing a combination of instruction sets. Theprocessing device 1002 may also be one or more special-purposeprocessing devices such as an application specific integrated circuit(ASIC), a field programmable gate array (FPGA), a digital signalprocessor (DSP), network processor, or the like. The processing device1002 is configured to execute instructions for performing any of theoperations and steps discussed herein.

The computer system 1000 may further include a network interface device1012. The computer system 1000 also may include a video display 1014(e.g., a liquid crystal display (LCD), a light-emitting diode (LED), anorganic light-emitting diode (OLED or Organic LED), or a cathode raytube (CRT)). The video display 1014 can represent the master display 136or any other suitable display. The computer system 1000 may include oneor more input devices 1016 (e.g., a keyboard, a mouse, the goniometer702, the wristband 704, the imaging device 116, or any other suitableinput). The computer system 1000 may include one or more output devices(e.g., a speaker 1018). In one illustrative example, the video display1014, the input device(s) 1016, and/or the speaker 1018 may be combinedinto a single component or device (e.g., an LCD touch screen).

The data storage device 1008 may include a computer-readable medium 1020on which the instructions 1022 (e.g., implementing the control system,the patient portal 114, the clinical portal 134, and/or any functionsperformed by any device and/or component depicted in the FIGS. anddescribed herein) embodying any one or more of the methodologies orfunctions described herein are stored. The instructions 1022 may alsoreside, completely or at least partially, within the main memory 1004and/or within the processing device 1002 during execution thereof by thecomputer system 1000. As such, the main memory 1004 and the processingdevice 1002 also constitute computer-readable media. The instructions1022 may further be transmitted or received over a network via thenetwork interface device 1012.

While the computer-readable storage medium 1020 is shown in theillustrative examples to be a single medium, the term “computer-readablestorage medium” should be taken to include a single medium or multiplemedia (e.g., a centralized or distributed database, and/or associatedcaches and servers) that store the one or more sets of instructions. Theterm “computer-readable storage medium” shall also be taken to includeany medium capable of storing, encoding or carrying a set ofinstructions for execution by the machine and that cause the machine toperform any one or more of the methodologies of the present disclosure.The term “computer-readable storage medium” shall accordingly be takento include, but not be limited to, solid-state memories, optical media,and magnetic media.

In one exemplary embodiment, the computer system 1000 includes the inputdevice 1016 (e.g., the master console 124 comprising the master device126) and the control system comprising the processing devices 1002(e.g., the master processing device) operatively coupled to the inputdevice 1016 and the treatment device 106. The system 1000 may compriseone or more memory devices (e.g., main memory 1004, data storage device1008, etc.) operatively coupled to the processing device 1002. The oneor more memory devices can be configured to store instructions 1022. Theprocessing device 1002 can be configured to execute the instructions1022 to receive the slave sensor data from the one or more slave sensors108, to use a manipulation of the master device 126 to generate amanipulation instruction, to transmit the manipulation instruction, andto use the manipulation instruction to cause the slave pressure system110 to activate. The instructions can be executed in real-time or nearreal-time.

The processing device 1002 can be further configured to use the slavesensor data to transmit an augmented image 400 to the video display(e.g., the master display 136). The healthcare provider may view theaugmented image 400 and/or virtually touch the augmented image using thevideo display 1014. In other words, the augmented image 400 may comprisea representation of the treatment device 106 and one or more body partsof the patient. The representation may be displayed in 2D, 3D, or anyother suitable dimension. As the healthcare provider conducts the remoteexamination during a telemedicine session, the augmented image 400 maychange to reflect the manipulations of the treatment device 106 and/orof any movement of the patient's one or more body parts.

The augmented image 400 can comprise one or more pressure indicators,temperature indicators, any other suitable indicator, or combinationthereof. Each pressure indicator can represent a measured level of force(i.e., based on the slave force measurements). Each temperatureindicator can represent a measured level of temperature (i.e., based onthe slave temperature measurements). For example, the pressureindicators and/or the temperature indicators may be different colors,each color associated with one of the measured levels of force andtemperature, respectively. The indicators may be displayed as a map. Themap may be a gradient map displaying the pressure indicators and/ortemperature indicators. The map may be overlaid over the augmentedimage. The map may be transmitted to the clinical portal, the masterdisplay, the patient portal, any other suitable display, or combinationthereof.

The processing device 1002 can be further configured to use the slavesensor data (e.g., the slave force measurements) to provide acorresponding level of measured force to the master device 126. In otherwords, while using the master device 126, the healthcare provider canessentially feel the measured levels of force exerted by the patient'sone or more body parts during the remote examination.

As the healthcare provider is virtually examining the patient, theprocessing device 1002 can use the master sensor data to generate andtransmit the manipulation instruction (e.g., a measured level of force)to manipulate the treatment device 106. In other words, as thehealthcare provider applies more force pressure) to the master device126, the master sensors 128 can detect the measured level of force andinstruct the treatment device 106 to apply a correlated measured levelof force. In some embodiments, the measured level of force can be basedon a proximity of the master device 126 to the representation. In otherwords, as the healthcare provider manipulates the master device 126closer to the representation and/or within the representation of thetreatment device 126 and/or the patient's one or more body parts, themaster sensors 128 can detect that the measured force has increased. Insome embodiments, the input device 1016 can comprise a pressuregradient. Using the pressure gradient, the processing device 1002 can beconfigured to cause the slave pressure system 110 to apply one or moremeasured levels of force to one or more sections 210 of the treatmentdevice 106.

In another exemplary embodiment, the computer system 1000 may includethe input device 1016 (e.g., the treatment device 106) and the controlsystem comprising the processing device 1002 (e.g., the slave processingdevice) operatively coupled to the input device 1016 and the masterdevice 126. The system 1000 may comprise one or more memory devices(e.g., main memory 1004, data storage device 1008, etc.) operativelycoupled to the processing device 1002. The one or more memory devicescan be configured to store instructions 1022. The processing device 1002can be configured to execute the instructions 1022 to receive the slavesensor data from the one or more slave sensors 108, to transmit theslave sensor data, to receive the manipulation instruction, and to usethe manipulation instruction to activate the slave pressure system 110.The instructions can be executed in real-time or near real-time.

In yet another embodiment, the computer system 1000 may include one ormore input devices 1016 (e.g., the master console 124 comprising themaster device 126, the treatment device 106, etc.) and the controlsystem comprising one or more processing devices 1002 (e.g., the masterprocessing device, the slave processing device) operatively coupled tothe input devices 1016. For example, the master processing device may beoperatively coupled to the master console 124 and the slave processingdevice may be operatively coupled to the treatment device 106. Thesystem 1000 may comprise one or more memory devices (e.g., master memorycoupled to the master processing device, slave memory coupled to theslave processing device, etc.) operatively coupled to the one or moreprocessing devices 1002. The one or more memory devices can beconfigured to store instructions 1022 (e.g., master instructions, slaveinstructions, etc.). The one or more processing devices 1002 (e.g., themaster processing device) can be configured to execute the masterinstructions 1022 to receive the slave sensor data from the slaveprocessing device, use a manipulation of the master device 126 togenerate a manipulation instruction, and transmit the manipulationinstruction to the slave processing device. The one or more processingdevices 1002 (e.g., the slave processing device) can be configured toexecute the slave instructions 1022 to receive the slave sensor datafrom the one or more slave sensors, to transmit the slave sensor data tothe master processing device, to receive the manipulation instructionfrom the master processing device, and to use the manipulationinstruction to activate the slave pressure system. The instructions canbe executed in real-time or near real-time.

In another exemplary embodiment, the computer system 1000 may includethe input device 1016 (e.g., the treatment device 800) and the controlsystem comprising the processing device 1002 (e.g., the slave processingdevice) operatively coupled to the input device 1016 and the mastercomputing device 122. The system 1000 may comprise one or more memorydevices (e.g., main memory 1004, data storage device 1008, etc.)operatively coupled to the processing device 1002. The one or morememory devices can be configured to store instructions 1022. Theprocessing device 1002 can be configured to execute the instructions1022 to receive a treatment plan (e.g., from a clinical portal 134) fora patient and to use the treatment plan to generate at least oneparameter. The at least one parameter can be at least one of a forceparameter, a resistance parameter, a range of motion parameter, atemperature parameter, a pain level parameter, an exercise sessionparameter, a vital sign parameter, and a time parameter. Responsive tothe at least one trigger condition occurring, the instructions canfurther cause the processing device 1002 to control at least oneoperation of the treatment device 800. The controlling of the at leastone operation of the device can comprise causing the treatment device800 to modify at least one of a volume, a pressure, a resistance, anangle, a speed, an angular or rotational velocity, and a time period.The processing device 1002 can be further configured to execute theinstructions 1022 to receive the slave sensor data (e.g., dataassociated with the at least one operation) from the one or more slavesensors 108. To determine the at least one trigger condition, theinstructions 1022 can further cause the processing device 1002 to use atleast one of the data, the at least one parameter, and a patient input.The instructions 1022 can be executed in real-time or near real-time.For example, a notification can be transmitted to the clinical portal134 in real-time or near real-time, the at least one adjusted parametercan be received in real-time or near real-time, and, using the at leastone adjusted parameter, the at least one operation of the treatmentdevice 800 can be controlled in real-time or near real-time. Theinstructions 1022 can be executed at any other suitable time. Forexample, the notification can be transmitted to a clinical portal 134 ata first time, the at least one adjusted parameter can be received by thetreatment device 800 at a second time, and, using the at least oneadjusted parameter, the at least one operation of the treatment device800 can be controlled at a third time subsequent to the first and secondtimes (i.e., subsequent to transmitting the notification and receivingthe at least one adjusted parameter).

FIG. 10 is not intended to be limiting: the system 1000 may include moreor fewer components than those illustrated in FIG. 10.

Any of the systems and methods described in this disclosure may be usedin connection with rehabilitation. Unless expressly stated otherwise, isto be understood that rehabilitation includes prehabilitation (alsoreferred to as “pre-habilitation” or “prehab”). Prehabilitation may beused as a preventative procedure or as a pre-surgical or pre-treatmentprocedure. Prehabilitation may include any action performed by or on apatient (or directed to be performed by or on a patient, including,without limitation, remotely or distally through telemedicine) to,without limitation, prevent or reduce a likelihood of injury (e.g.,prior to the occurrence of the injury); improve recovery time subsequentto surgery; improve strength subsequent to surgery; or any of theforegoing with respect to any non-surgical clinical treatment plan to beundertaken for the purpose of ameliorating or mitigating injury,dysfunction, or other negative consequence of surgical or non-surgicaltreatment on any external or internal part of a patient's body. Forexample, a mastectomy may require prehabilitation to strengthen musclesor muscle groups affected directly or indirectly by the mastectomy. As afurther non-limiting example, the removal of an intestinal tumor, therepair of a hernia, open-heart surgery or other procedures performed oninternal organs or structures, whether to repair those organs orstructures, to excise them or parts of them, to treat them, etc., canrequire cutting through and harming numerous muscles and muscle groupsin or about, without limitation, the abdomen, the ribs and/or thethoracic cavity. Prehabilitation can improve a patient's speed ofrecovery, measure of quality of life, level of pain, etc. in all theforegoing procedures. In one embodiment of prehabilitation, apre-surgical procedure or a pre-non-surgical-treatment may include oneor more sets of exercises for a patient to perform prior to suchprocedure or treatment. The patient may prepare an area of his or herbody for the surgical procedure by performing the one or more sets ofexercises, thereby strengthening muscle groups, improving existingand/or establishing new muscle memory, enhancing mobility, improvingblood flow, and/or the like.

In some embodiments, the systems and methods described herein may useartificial intelligence and/or machine learning to generate aprehabilitation treatment plan for a user. Additionally, oralternatively, the systems and methods described herein may useartificial intelligence and/or machine learning to recommend an optimalexercise machine configuration for a user. For example, a data model maybe trained on historical data such that the data model may be providedwith input data relating to the user and may generate output dataindicative of a recommended exercise machine configuration for aspecific user. Additionally, or alternatively, the systems and methodsdescribed herein may use machine learning and/or artificial intelligenceto generate other types of recommendations relating to prehabilitation,such as recommended reading material to educate the patient, arecommended health professional specialist to contact, and/or the like.

Consistent with the above disclosure, the examples of systems andmethods enumerated in the following clauses are specificallycontemplated and are intended as a non-limiting set of examples.

Clause 1. A computer-implemented system, comprising:

a treatment device configured to be manipulated by a user while the userperforms a treatment plan;

a patient interface comprising an output device configured to presenttelemedicine information associated with a telemedicine session; and

a processing device configured to:

-   -   receive a treatment plan for a patient;    -   during the telemedicine session, use the treatment plan to        generate at least one parameter; and    -   responsive to at least one trigger condition occurring, control        at least one operation of the treatment device.

Clause 2. The computer-implemented system of any clause herein, whereinthe treatment device comprises a sensor for detecting data associatedwith the at least one operation.

Clause 3. The computer-implemented system of any clause herein, whereinthe processing device is configured to receive the data from the sensorin real-time or near real-time.

Clause 4. The computer-implemented system of any clause herein, wherein,to determine the at least one trigger condition, the one or moreprocessing devices are configured to use at least one of the data, theat least one parameter, and a patient input.

Clause 5. The computer-implemented system of any clause herein, whereinthe controlling of the at least one operation of the device comprisescausing the device to modify at least one of a volume, a pressure, aresistance, an angle, a speed, an angular or rotational velocity, and atime period.

Clause 6. The computer-implemented system of any clause herein, whereinthe at least one parameter is at least one of a force parameter, aresistance parameter, a range of motion parameter, a temperatureparameter, a pain level parameter, an exercise session parameter, avital sign parameter, and a time parameter.

Clause 7. A system for a remote examination of a patient, comprising:

a master console comprising a master device;

a treatment device comprising one or more slave sensors and a slavepressure system; and

a control system comprising one or more processing devices operativelycoupled to the master console and the treatment device, wherein the oneor more processing devices are configured to:

-   -   receive slave sensor data from the one or more slave sensors;    -   use a manipulation of the master device to generate a        manipulation instruction;    -   transmit the manipulation instruction; and    -   use the manipulation instruction to cause the slave pressure        system to activate.

Clause 8. The system of any clause herein, wherein the master devicecomprises master sensors for detecting master sensor data associatedwith the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 9. The system of any clause herein, wherein the slave sensor datacomprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the master pressure system.

Clause 10. The system of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the second master pressuresystem.

Clause 11. The system of any clause herein, wherein the one or moreprocessing devices are further configured to:

use the slave sensor data to transmit an augmented image to a masterdisplay.

Clause 12. The system of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 13. The system of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 14. The system of any clause herein, wherein the master devicecomprises a pressure gradient; and

wherein, using the pressure gradient, the one or more processing devicesare configured to cause the slave pressure system to apply one or moremeasured levels of force to one or more sections of the treatmentdevice.

Clause 15. The system of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 16. The system of any clause herein, wherein the manipulationinstruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 17. The system of any clause herein, wherein the one or moreprocessing devices are further configured to:

transmit the manipulation instruction in real-time or near real-time;and

cause the slave pressure system to activate in real-time or nearreal-time.

Clause 18. The system of any clause herein, wherein the master devicecomprises at least one of a glove device, a joystick, and a model of thetreatment device.

Clause 19. The system of any clause herein, wherein the treatment devicecomprises at least one of a brace, a cap, a mat, and a wrap.

Clause 20. The system of any clause herein, further comprising one ormore memory devices operatively coupled to the one or more processingdevices, wherein the one or more memory devices stores instructions, andwherein the one or more processing devices are configured to execute theinstructions.

Clause 21. A method for operating a system for remote examination of apatient, comprising:

receiving slave sensor data from one or more slave sensors;

based on a manipulation of a master device, generating a manipulationinstruction;

transmitting the manipulation instruction; and

based on the manipulation instruction, causing a slave pressure systemto activate.

Clause 22. The method of any clause herein, wherein the master devicecomprises master sensors for detecting master sensor data associatedwith the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 23. The method of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, activating the masterpressure system.

Clause 24. The method of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the second master pressuresystem.

Clause 25. The method of any clause herein, further comprising:

use the slave sensor data to transmitting an augmented image.

Clause 26. The method of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 27. The method of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 28. The method of any clause herein, wherein the master devicecomprises a pressure gradient; and

wherein, using the pressure gradient, causing the slave pressure systemto apply one or more measured levels of force to one or more sections ofthe treatment device.

Clause 29. The method of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 30. The method of any clause herein, wherein the manipulationinstruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 31. The method of any clause herein, further comprising:

transmitting the manipulation instruction in real-time or nearreal-time; and

causing the slave pressure system to activate in real-time or nearreal-time.

Clause 32. The method of any clause herein, wherein the master devicecomprises at least one of a glove device, a joystick, and a model of thetreatment device.

Clause 33. The method of any clause herein, wherein the treatment devicecomprises at least one of a brace, a cap, a mat, and a wrap.

Clause 34. A tangible, non-transitory computer-readable storage mediumstoring instructions that, when executed, cause a processing device to:

receive slave sensor data from one or more slave sensors;

based on a manipulation of a master device, generate a manipulationinstruction;

transmit the manipulation instruction; and

use the manipulation instruction to cause a slave pressure system toactivate.

Clause 35. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the master device comprises master sensorsfor detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 36. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the slave sensor data comprises slaveforce measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, activate the masterpressure system.

Clause 37. The tangible, non-transitory computer-readable storage mediumof any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the second master pressuresystem.

Clause 38. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the instructions further cause theprocessing device to:

use the slave sensor data to transmit an augmented image.

Clause 39. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the slave sensor data comprises slaveforce measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 40. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the slave sensor data comprises slavetemperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 41. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the master device comprises a pressuregradient; and

wherein, using the pressure gradient, cause the slave pressure system toapply one or more measured levels of force to one or more sections ofthe treatment device.

Clause 42. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the augmented image comprises arepresentation of at least one of the treatment device and a body partof the patient, and wherein the representation is in 2D or 3D.

Clause 43. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the manipulation instruction comprises ameasured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 44. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the instructions further cause theprocessing device to:

transmit the manipulation instruction in real-time or near real-time;and

cause the slave pressure system to activate in real-time or nearreal-time.

Clause 45. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the master device comprises at least oneof a glove device, a joystick, and a model of the treatment device.

Clause 46. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the treatment device comprises at leastone of a brace, a cap, a mat, and a wrap.

Clause 47. A system for a remote examination of a patient, comprising:

a master console comprising a master device;

a treatment device comprising one or more slave sensors and a slavepressure system; and

a control system comprising one or more processing devices operativelycoupled to the master console and the treatment device, wherein the oneor more processing devices are configured to:

-   -   receive slave sensor data from the one or more slave sensors;    -   transmit the slave sensor data;    -   receive a manipulation instruction; and    -   use the manipulation instruction to activate the slave pressure        system.

Clause 48. The system of any clause herein, wherein the manipulationinstruction is based on a manipulation of the master device.

Clause 49. The system of any clause herein, wherein the master devicecomprises master sensors for detecting master sensor data associatedwith the manipulation; and wherein the manipulation instruction is basedon the master sensor data.

Clause 50. The system of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the second master pressuresystem.

Clause 51. The system of any clause herein, wherein the one or moreprocessing devices are further configured to:

use the slave sensor data to transmit an augmented image to the masterconsole.

Clause 52. The system of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to cause the master pressure system toactivate.

Clause 53. The system of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 54. The system of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 55. The system of any clause herein, wherein the master devicecomprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressuresystem comprises applying one or more measured levels of force to one ormore sections of the treatment device.

Clause 56. The system of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 57. The system of any clause herein, wherein the manipulationinstruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 58. The system of any clause herein, wherein the one or moreprocessing devices are further configured to:

receive the manipulation instruction in real-time or near real-time; and

activate the slave pressure system in real-time or near real-time.

Clause 59. The system of any clause herein, wherein the master devicecomprises at least one of a glove device, a joystick, and a model of thetreatment device.

Clause 60. The system of any clause herein, wherein the treatment devicecomprises at least one of a brace, a cap, a mat, and a wrap.

Clause 61. The system of any clause herein, further comprising one ormore memory devices operatively coupled to the one or more processingdevices, wherein the one or more memory devices stores instructions, andwherein the one or more processing devices are configured to execute theinstructions.

Clause 62. A method for operating a system for remote examination of apatient, comprising:

receiving slave sensor data from one or more slave sensors;

transmitting the slave sensor data;

receiving a manipulation instruction; and

based on the manipulation instruction, activating a slave pressuresystem.

Clause 63. The method of any clause herein, wherein the manipulationinstruction is based on a manipulation of a master device.

Clause 64. The method of any clause herein, wherein the master devicecomprises master sensors for detecting master sensor data associatedwith the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 65. The method of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the second master pressuresystem.

Clause 66. The method of any clause herein, further comprising:

use the slave sensor data to transmitting an augmented image to themaster console.

Clause 67. The method of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, causing the masterpressure system to activate.

Clause 68. The method of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 69. The method of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 70. The method of any clause herein, wherein the master devicecomprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressuresystem comprises applying one or more measured levels of force to one ormore sections of the treatment device.

Clause 71. The method of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 72. The method of any clause herein, wherein the manipulationinstruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 73. The method of any clause herein, further comprising:

receiving the manipulation instruction in real-time or near real-time;and

activating the slave pressure system in real-time or near real-time.

Clause 74. The method of any clause herein, wherein the master devicecomprises at least one of a glove device, a joystick, and a model of thetreatment device.

Clause 75. The method of any clause herein, wherein the treatment devicecomprises at least one of a brace, a cap, a mat, and a wrap.

Clause 76. A tangible, non-transitory computer-readable storage mediumstoring instructions that, when executed, cause a processing device to:

receive slave sensor data from one or more slave sensors;

transmit the slave sensor data;

receive a manipulation instruction; and

use the manipulation instruction to activate a slave pressure system.

Clause 77. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the manipulation instruction is based on amanipulation of a master device.

Clause 78. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the master device comprises master sensorsfor detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 79. The tangible, non-transitory computer-readable storage mediumof any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processingdevices are further configured to activate the second master pressuresystem.

Clause 80. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the instructions further cause theprocessing device to:

use the slave sensor data to transmit an augmented image to the masterconsole.

Clause 81. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the slave sensor data comprises slaveforce measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, cause the masterpressure system to activate.

Clause 82. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the slave sensor data comprises slaveforce measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 83. The method of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 84. The method of any clause herein, wherein the master devicecomprises a pressure gradient; and wherein, using the pressure gradient,activating the slave pressure system comprises applying one or moremeasured levels of force to one or more sections of the treatmentdevice.

Clause 85. The method of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 86. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the manipulation instruction comprises ameasured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 87. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the instructions further cause theprocessing device to:

receive the manipulation instruction in real-time or near real-time; and

activate the slave pressure system in real-time or near real-time.

Clause 88. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the master device comprises at least oneof a glove device, a joystick, and a model of the treatment device.

Clause 89. The tangible, non-transitory computer-readable storage mediumof any clause herein, wherein the treatment device comprises at leastone of a brace, a cap, a mat, and a wrap.

Clause 90. A system for a remote examination of a patient, comprising:

a master console comprising a master device;

a treatment device comprising one or more slave sensors and a slavepressure system; and

a control system comprising a master processing device and a slaveprocessing device, wherein the master processing device is operativelycoupled to the master console and the slave processing device isoperatively coupled to the treatment device;

-   -   wherein the master processing device is configured to:    -   receive slave sensor data from the slave processing device;    -   use a manipulation of the master device to generate a        manipulation instruction; and    -   transmit the manipulation instruction to the slave processing        device; and

wherein the slave processing device is configured to:

-   -   receive the slave sensor data from the one or more slave        sensors;    -   transmit the slave sensor data to the master processing device;    -   receive the manipulation instruction from the master processing        device; and    -   use the manipulation instruction to activate the slave pressure        system.

Clause 91. The system of any clause herein, wherein the master devicecomprises master sensors for detecting master sensor data associatedwith the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 92. The system of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the master processingdevice is further configured to activate the master pressure system.

Clause 93. The system of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the master processingdevice is further configured to activate the second master pressuresystem.

Clause 94. The system of any clause herein, wherein the masterprocessing device is further configured to:

use the slave sensor data to transmit an augmented image to a masterdisplay.

Clause 95. The system of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 96. The system of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 97. The system of any clause herein, wherein the master devicecomprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressuresystem comprises applying one or more measured levels of force to one ormore sections of the treatment device.

Clause 98. The system of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 99. The system of any clause herein, wherein the manipulationinstruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 100. The system of any clause herein, wherein the manipulationinstruction is transmitted in real-time or near real-time; and

wherein the slave pressure system is activated in real-time or nearreal-time.

Clause 101. The system of any clause herein, wherein the master devicecomprises at least one of a glove device, a joystick, and a model of thetreatment device.

Clause 102. The system of any clause herein, wherein the treatmentdevice comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 103. The system of any clause herein, further comprising:

a master memory device operatively coupled to the master processingdevice, wherein the master memory device stores master instructions, andwherein the master processing device is configured to execute the masterinstructions; and

a slave memory device operatively coupled to the slave processingdevice, wherein the slave memory device stores slave instructions, andwherein the slave processing device is configured to execute the slaveinstructions.

Clause 104. A method for operating a remote examination of a patient,comprising:

causing a master processing device to:

-   -   receive slave sensor data from the slave processing device;    -   use a manipulation of a master device to generate a manipulation        instruction; and    -   transmit the manipulation instruction to the slave processing        device; and

causing a slave processing device to:

-   -   receive the slave sensor data from the one or more slave        sensors;    -   transmit the slave sensor data to the master processing device;    -   receive the manipulation instruction from the master processing        device; and    -   use the manipulation instruction to activate the slave pressure        system.

Clause 105. The method of any clause herein, wherein the master devicecomprises master sensors for detecting master sensor data associatedwith the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 106. The method of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the master device comprises a master pressure system; and

causing the master processing device, based on the slave forcemeasurements, to activate the master pressure system.

Clause 107. The method of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the master processingdevice is further configured to activate the second master pressuresystem.

Clause 108. The method of any clause herein, further causing the masterprocessing device to:

use the slave sensor data to transmit an augmented image to a masterdisplay.

Clause 109. The method of any clause herein, wherein the slave sensordata comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 110. The method of any clause herein, wherein the slave sensordata comprises slave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 111. The method of any clause herein, wherein the master devicecomprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressuresystem comprises applying one or more measured levels of force to one ormore sections of the treatment device.

Clause 112. The method of any clause herein, wherein the augmented imagecomprises a representation of at least one of the treatment device and abody part of the patient, and wherein the representation is in 2D or 3D.

Clause 113. The method of any clause herein, wherein the manipulationinstruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 114. The method of any clause herein, wherein the manipulationinstruction is transmitted in real-time or near real-time; and

wherein the slave pressure system is activated in real-time or nearreal-time.

Clause 115. The method of any clause herein, wherein the master devicecomprises at least one of a glove device, a joystick, and a model of thetreatment device.

Clause 116. The method of any clause herein, wherein the treatmentdevice comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 117. A tangible, non-transitory computer-readable storage mediumstoring instructions that, when executed,

cause a master processing device to:

-   -   receive slave sensor data from the slave processing device;    -   use a manipulation of a master device to generate a manipulation        instruction; and    -   transmit the manipulation instruction to the slave processing        device; and

cause a slave processing device to:

-   -   receive the slave sensor data from the one or more slave        sensors;    -   transmit the slave sensor data to the master processing device;    -   receive the manipulation instruction from the master processing        device; and    -   use the manipulation instruction to activate the slave pressure        system.

Clause 118. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the master device comprises mastersensors for detecting master sensor data associated with themanipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 119. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the slave sensor data comprisesslave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the master processingdevice is further configured to activate the master pressure system.

Clause 120. The tangible, non-transitory computer-readable storagemedium of any clause herein, further comprising:

a second master device comprising a second master pressure system;

wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the master processingdevice is further configured to activate the second master pressuresystem.

Clause 121. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein instructions further cause themaster processing device to:

use the slave sensor data to transmit an augmented image to a masterdisplay.

Clause 122. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the slave sensor data comprisesslave force measurements;

wherein the augmented image comprises one or more pressure indicators;and

wherein the one or more pressure indicators are based on the slave forcemeasurements.

Clause 123. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the slave sensor data comprisesslave temperature measurements;

wherein the augmented image comprises one or more temperatureindicators; and

wherein the one or more temperature indicators are based on the slavetemperature measurements.

Clause 124. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the master device comprises apressure gradient; and

wherein, using the pressure gradient, activating the slave pressuresystem comprises applying one or more measured levels of force to one ormore sections of the treatment device.

Clause 125. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the augmented image comprises arepresentation of at least one of the treatment device and a body partof the patient, and wherein the representation is in 2D or 3D.

Clause 126. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the manipulation instructioncomprises a measured level of force; and

wherein the measured level of force is based on a proximity of themaster device to the representation.

Clause 127. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the manipulation instruction istransmitted in real-time or near real-time; and

wherein the slave pressure system is activated in real-time or nearreal-time.

Clause 128. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the master device comprises atleast one of a glove device, a joystick, and a model of the treatmentdevice.

Clause 129. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the treatment device comprises atleast one of a brace, a cap, a mat, and a wrap.

Clause 130. The tangible, non-transitory computer-readable storagemedium of any clause herein, further comprising:

a master memory device operatively coupled to the master processingdevice, wherein the master memory device stores master instructions, andwherein the master processing device is configured to execute the masterinstructions; and

a slave memory device operatively coupled to the slave processingdevice, wherein the slave memory device stores slave instructions, andwherein the slave processing device is configured to execute the slaveinstructions.

Clause 131. A system for enabling a remote adjustment of a device,comprising:

a control system comprising one or more processing devices operativelycoupled to the device, wherein the one or more processing devices areconfigured to:

-   -   receive a treatment plan for a patient;    -   use the treatment plan to generate at least one parameter; and    -   responsive to at least one trigger condition occurring, control        at least one operation of the device.

Clause 132. The system of any clause herein, wherein the devicecomprises a sensor for detecting data associated with the at least oneoperation.

Clause 133. The system of any clause herein, wherein the one or moreprocessing devices are configured to receive the data from the sensor inreal-time or near real-time.

Clause 134. The system of any clause herein, wherein, to determine theat least one trigger condition, the one or more processing devices areconfigured to use at least one of the data, the at least one parameter,and a patient input.

Clause 135. The system of any clause herein, wherein the controlling ofthe at least one operation of the device comprises causing the device tomodify at least one of a volume, a pressure, a resistance, an angle, aspeed, an angular or rotational velocity, and a time period.

Clause 136. The system of any clause herein, wherein the at least oneparameter is at least one of a force parameter, a resistance parameter,a range of motion parameter, a temperature parameter, a pain levelparameter, an exercise session parameter, a vital sign parameter, and atime parameter.

Clause 137. The system of any clause herein, wherein the one or moreprocessing devices are configured to receive the treatment plan from aclinical portal.

Clause 138. The system of any clause herein, wherein the one or moreprocessing devices are further configured to:

transmit a notification to a clinical portal in real-time or nearreal-time;

receive at least one adjusted parameter in real-time or near real-time;and

using the at least one adjusted parameter, control the at least oneoperation of the device in real-time or near real-time.

Clause 139. The system of any clause herein, wherein the one or moreprocessing devices are further configured to:

transmit a notification to a clinical portal;

receive at least one adjusted parameter; and

using the at least one adjusted parameter, control the at least oneoperation of the device at a time subsequent to receiving the at leastone adjusted parameter.

Clause 140. The system of any clause herein, wherein the devicecomprises at least one of a physical therapy device, a brace, a cap, amat, and a wrap.

Clause 141. A method for enabling a remote adjustment of a device,comprising:

receiving a treatment plan for a patient;

using the treatment plan to generate at least one parameter; and

responsive to at least one trigger condition occurring, controlling atleast one operation of the device.

Clause 142. The method of any clause herein, wherein the devicecomprises a sensor for detecting data associated with the at least oneoperation.

Clause 143. The method of any clause herein, wherein the data isreceived from the sensor in real-time or near real-time.

Clause 144. The method of any clause herein, further comprising:

to determine the at least one trigger condition, using at least one ofthe data, the at least one parameter, and a patient input.

Clause 145. The method of any clause herein, wherein the controlling ofthe at least one operation of the device comprises causing the device tomodify at least one of a volume, a pressure, a resistance, an angle, aspeed, an angular or rotational velocity, and a time period.

Clause 146. The method of any clause herein, wherein the at least oneparameter is at least one of a force parameter, a resistance parameter,a range of motion parameter, a temperature parameter, a pain levelparameter, an exercise session parameter, a vital sign parameter, and atime parameter.

Clause 147. The method of any clause herein, wherein the treatment planis received from a clinical portal.

Clause 148. The method of any clause herein, further comprising:

transmitting a notification to a clinical portal in real-time or nearreal-time;

receiving at least one adjusted parameter in real-time or nearreal-time; and

using the at least one adjusted parameter to control the at least oneoperation of the device in real-time or near real-time.

Clause 149. The method of any clause herein, further comprising:

transmitting a notification to a clinical portal;

receiving at least one adjusted parameter; and

using the at least one adjusted parameter to control the at least oneoperation of the device at a time subsequent to receiving the at leastone adjusted parameter.

Clause 150. The method of any clause herein, wherein the devicecomprises at least one of a physical therapy device, a brace, a cap, amat, and a wrap.

Clause 151. A tangible, non-transitory computer-readable storage mediumstoring instructions that, when executed, cause a processor to:

receive a treatment plan for a patient;

use the treatment plan to generate at least one parameter; and

responsive to at least one trigger condition occurring, control at leastone operation of a device.

Clause 152. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the device comprises a sensor fordetecting data associated with the at least one operation.

Clause 153. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the instructions further cause theprocessor to receive the data from the sensor in real-time or nearreal-time.

Clause 154. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein, to determine the at least onetrigger condition, the instructions further cause the processor to useat least one of the data, the at least one parameter, and a patientinput.

Clause 155. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the controlling of the at least oneoperation of the device comprises causing the device to modify at leastone of a volume, a pressure, a resistance, an angle, a speed, an angularor rotational velocity, and a time period.

Clause 156. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the at least one parameter is atleast one of a force parameter, a resistance parameter, a range ofmotion parameter, a temperature parameter, a pain level parameter, anexercise session parameter, a vital sign parameter, and a timeparameter.

Clause 157. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the treatment plan is received froma clinical portal.

Clause 158. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the instructions further cause theprocessor to:

transmit a notification to a clinical portal in real-time or nearreal-time;

receive at least one adjusted parameter in real-time or near real-time;and

using the at least one adjusted parameter, control the at least oneoperation of the device in real-time or near real-time.

Clause 159. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the instructions further cause theprocessor to:

transmit a notification to a clinical portal;

receive at least one adjusted parameter; and

using the at least one adjusted parameter, control the at least oneoperation of the device at a time subsequent to receiving the at leastone adjusted parameter.

Clause 160. The tangible, non-transitory computer-readable storagemedium of any clause herein, wherein the device comprises at least oneof a physical therapy device, a brace, a cap, a mat, and a wrap.

Consistent with the above disclosure, the examples of assembliesenumerated in the following clauses are specifically contemplated andare intended as a non-limiting set of examples.

No part of the description in this application should be read asimplying that any particular element, step, or function is an essentialelement that must be included in the claim scope. The scope of patentedsubject matter is defined only by the claims. Moreover, none of theclaims is intended to invoke 25 U.S.C. § 104(f) unless the exact words“means for” are followed by a participle.

The foregoing description, for purposes of explanation, use specificnomenclature to provide a thorough understanding of the describedembodiments. However, it should be apparent to one skilled in the artthat the specific details are not required to practice the describedembodiments. Thus, the foregoing descriptions of specific embodimentsare presented for purposes of illustration and description. They are notintended to be exhaustive or to limit the described embodiments to theprecise forms disclosed. It should be apparent to one of ordinary skillin the art that many modifications and variations are possible in viewof the above teachings.

The above discussion is meant to be illustrative of the principles andvarious embodiments of the present invention. Once the above disclosureis fully appreciated, numerous variations and modifications will becomeapparent to those skilled in the art. It is intended that the followingclaims be interpreted to embrace all such variations and modifications.

What is claimed is:
 1. A computer-implemented system, comprising: atreatment device configured to be manipulated by a user while the userperforms a treatment plan; a patient interface comprising an outputdevice configured to present telemedicine information associated with atelemedicine session; and a processing device configured to: receive atreatment plan for a patient; during the telemedicine session, use thetreatment plan to generate at least one parameter; and responsive to atleast one trigger condition occurring, control at least one operation ofthe treatment device, while the treatment device is operating, tofacilitate user compliance with the treatment plan.
 2. The system ofclaim 1, wherein the treatment device comprises a sensor for detectingdata associated with the at least one operation.
 3. The system of claim2, wherein the processing device is configured to receive the data fromthe sensor in real-time or near real-time.
 4. The system of claim 3,wherein, to determine the at least one trigger condition, the one ormore processing devices are configured to use at least one of the data,the at least one parameter, and a patient input.
 5. The system of claim1, wherein the controlling of the at least one operation of the devicecomprises causing the device to modify at least one of a volume, apressure, a resistance, an angle, a speed, an angular or rotationalvelocity, and a time period.
 6. The system of claim 1, wherein the atleast one parameter is at least one of a force parameter, a resistanceparameter, a range of motion parameter, a temperature parameter, a painlevel parameter, an exercise session parameter, a vital sign parameter,and a time parameter.
 7. A system for enabling a remote adjustment of adevice, comprising: a control system comprising one or more processingdevices operatively coupled to the device, wherein the one or moreprocessing devices are configured to: receive a treatment plan for apatient; use the treatment plan to generate at least one parameter; andresponsive to at least one trigger condition occurring, control at leastone operation of the device, while the treatment device is operating, tofacilitate user compliance with the treatment plan.
 8. The system ofclaim 7, wherein the device comprises a sensor for detecting dataassociated with the at least one operation.
 9. The system of claim 8,wherein the one or more processing devices are configured to receive thedata from the sensor in real-time or near real-time.
 10. The system ofclaim 9, wherein, to determine the at least one trigger condition, theone or more processing devices are configured to use at least one of thedata, the at least one parameter, and a patient input.
 11. The system ofclaim 7, wherein the controlling of the at least one operation of thedevice comprises causing the device to modify at least one of a volume,a pressure, a resistance, an angle, a speed, an angular or rotationalvelocity, and a time period.
 12. The system of claim 7, wherein the atleast one parameter is at least one of a force parameter, a resistanceparameter, a range of motion parameter, a temperature parameter, a painlevel parameter, an exercise session parameter, a vital sign parameter,and a time parameter.
 13. The system of claim 7, wherein the one or moreprocessing devices are configured to receive the treatment plan from aclinical portal.
 14. The system of claim 7, wherein the one or moreprocessing devices are further configured to: transmit a notification toa clinical portal in real-time or near real-time; receive at least oneadjusted parameter in real-time or near real-time; and using the atleast one adjusted parameter, control the at least one operation of thedevice in real-time or near real-time.
 15. The system of claim 7,wherein the one or more processing devices are further configured to:transmit a notification to a clinical portal; receive at least oneadjusted parameter; and using the at least one adjusted parameter,control the at least one operation of the device at a time subsequent toreceiving the at least one adjusted parameter.
 16. The system of claim7, wherein the device comprises at least one of a physical therapydevice, a brace, a cap, a mat, and a wrap.
 17. A method for enabling aremote adjustment of a device, comprising: receiving a treatment planfor a patient; using the treatment plan to generate at least oneparameter; and responsive to at least one trigger condition occurring,controlling at least one operation of the device, while the treatmentdevice is operating, to facilitate user compliance with the treatmentplan.
 18. The method of claim 17, wherein the device comprises a sensorfor detecting data associated with the at least one operation.
 19. Themethod of claim 18, wherein the data is received from the sensor inreal-time or near real-time.
 20. The method of claim 19, furthercomprising: to determine the at least one trigger condition, using atleast one of the data, the at least one parameter, and a patient input.21. The method of claim 17, wherein the controlling of the at least oneoperation of the device comprises causing the device to modify at leastone of a volume, a pressure, a resistance, an angle, a speed, an angularor rotational velocity, and a time period.
 22. The method of claim 17,wherein the at least one parameter is at least one of a force parameter,a resistance parameter, a range of motion parameter, a temperatureparameter, a pain level parameter, an exercise session parameter, avital sign parameter, and a time parameter.
 23. The method of claim 17,wherein the treatment plan is received from a clinical portal.
 24. Themethod of claim 17, further comprising: transmitting a notification to aclinical portal in real-time or near real-time; receiving at least oneadjusted parameter in real-time or near real-time; and using theadjusted parameter to control the at least one operation of the devicein real-time or near real-time.
 25. The method of claim 17, furthercomprising: transmitting a notification to a clinical portal; receivingat least one adjusted parameter; and using the at least one adjustedparameter to control the at least one operation of the device at a timesubsequent to receiving the at least one adjusted parameter.
 26. Themethod of claim 17, wherein the device comprises at least one of aphysical therapy device, a brace, a cap, a mat, and a wrap.
 27. Atangible, non-transitory computer-readable storage medium storinginstructions that, when executed, cause a processor to: receive atreatment plan for a patient; use the treatment plan to generate atleast one parameter; and responsive to at least one trigger conditionoccurring, control at least one operation of a device, while thetreatment device is operating, to facilitate user compliance with thetreatment plan.
 28. The tangible, non-transitory computer-readablestorage medium of claim 27, wherein the treatment plan is received froma clinical portal.
 29. The tangible, non-transitory computer-readablestorage medium of claim 27, wherein the instructions further cause theprocessor to: transmit a notification to a clinical portal in real-timeor near real-time; receive at least one adjusted parameter in real-timeor near real-time; and using the at least one adjusted parameter,control the at least one operation of the device in real-time or nearreal-time.
 30. The tangible, non-transitory computer-readable storagemedium of claim 27, wherein the instructions further cause the processorto: transmit a notification to a clinical portal; receive at least oneadjusted parameter; and using the at least one adjusted parameter,control the at least one operation of the device at a time subsequent toreceiving the at least one adjusted parameter.